Question
QUESTION: I have a strange pain in my foot that has been occurring for about 5 days so far.  It is on the side of my right foot, along the fifth metatarsal, nearer the small toe as opposed to the heel.  
Some observations:
-I did not suffer any obvious trauma.
-It only hurts when I walk, and is worse when I am wearing shoes. I walk and run barefoot and it never hurts then. I did yoga today with no pain, and there is no pain while sitting and resting the foot.
-The pain is not persistent.
-No part of the foot is swollen, sore or bruised (foot looks completely normal.)
-Palpating all parts of the foot don't produce pain in any location.   
-The only way I can reproduce the pain (besides walking in shoes) is standing and placing most of my weight over onto the side of the foot where the pain occurs.  
-I can walk and bear weight on my toes (ball of foot) or heels without any pain.
-I have full range of motion in all of my toes without any associated pain.  
-I have spent a day each in tennis shoes, custom-molded orthotics, Chaco sandals, and barefoot shoes (though I am inclined to wear the sandals or barefoot shoes on a daily basis) and none has helped any with the pain (except going completely barefoot.)

Any clue what might be causing this and any remedy that could try?

ANSWER: Kristin, do you have a bony prominence on the side of your foot?  I have patients with similar symptoms as yours that have a Tailor's bunion.  This type of bunion occurs on the 5th toe rather than like a traditional bunion on the big toe.  With a Tailor's bunion it is common to have pressure in shoes that cause pain because it's compressing a nerve or causing bursitis.  When the pressure is relieved from shoes, the pain usually resolves.  Have you tried any padding or gel sleeves to the area to relieve pressure?  Sometimes they can help prevent friction and irritation from occurring.  If you have any other questions, please let me know, and I will try to answer them for you.

Sincerely,

Dr. Leslie Johnston
Tampa, FL
Advanced Podiatry

http://www.thetampapodiatrist.com
http://tampafootandanklepain.blogspot.com/
http://www.tampacryosurgery.com
http://katzpodiatristtampa.blogspot.com
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---------- FOLLOW-UP ----------

QUESTION: Thank you for your insights.
It doesn't appear that I have a Tailor's Bunion.  My foot is normal shaped without any bony abnormalities, but I do have a wide footbox at the toes.  My previous podiatrist said this is natural and is evidence that I haven't worn improper footwear and misshapen my foot and toes (this is true).  My foot seems to be feeling a little bit better with rest, though when I put shoes back on (I've only been wearing sandals to avoid any toe rub), it feels okay for 10-20 minutes walking and then the pain is back.  
Is there any nerve that could be being compressed on the underside of the foot when I wear shoes, but that wouldn't if I'm barefoot.  It feels like it could be nerve pain, probably 3-4 on the pain scale (out of 10).  It's a dull pain that flares up slightly when I roll through the walking motion on the foot, but generally I don't have any pain when standing still.

Answer
Kristin, yes there are several nerves that course through the interspaces of the metatarsals.  Compression can cause them to produce nerve pain.  Without actually performing an exam, it would be hard to determine which one it is.  If you have any fat pad atrophy (the padding on the ball of the foot becomes thin and doesn't provide enough padding for the metatarsal heads) then that could cause similar symptoms as well.

Sincerely,

Dr. Leslie Johnston
Tampa, FL
Advanced Podiatry

http://www.thetampapodiatrist.com
http://tampafootandanklepain.blogspot.com/
http://www.tampacryosurgery.com
http://katzpodiatristtampa.blogspot.com
http://twitter.com/TampaPodiatrist
http://www.notoenailfungus.com
http://www.vibranttampatoenails.com  
Advanced Podiatry Facebook Page
http://www.facebook.com/profile.php?id=100000260088035