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Burning Feet

Posted by HEast on 5/02/01 at hrmin (046415)

I have diagnosed PF with heel spur x 2 years. Wear prescription orthotics has all but eliminated the heelp pain. Now, however, I have severe burning and tingling in the balls of both feet. Not a blood sugar problem. Can't walk or stand for any length of time without pain and burning. Even when sitting or resting, I have burning and tingling in balls of fee. On left foot, I get what feels like a 'knot or rock' just behind my third and fourth toes. Feels like my sock is balled up, but it isn't. Also when I walk, I feel something 'click and slid' running from the ball of my left foot out to my fourth toe. My Podiatrist said I might have a nerve sliding in that area and gave steriod injection and prescribed 600 mg Motrin. No effect at all. Any help or info.

Re: Burning Feet

Dr. Biehler on 5/02/01 at 11:43 (046422)

Burning and tingling in the balls of the feet can be caused by the metatarsal heads bearing too much weight. This can cause a bursitis or capsulitis. If this is the case, sometimes a metatarsal pad added to the orthotics can help distribute the presure more evenly and help resolve the problem . If the metatarsal themselves have become plantarflexed and if the pad doesn't work, it is sometimes possible to raise the heads in a surgical procedure. Dr. B.

Re: Burning Feet

Pauline on 5/02/01 at 20:33 (046445)

When I tried wearing my custom orthotics I experienced a similar feeling,
I also notice it when I try wearing a higher heeled shoe. Not spikes but
about 2'.

I attributed the burning when wearing my orthotic to excessive heat because the material didn't breath. I never got the burning without the orthotic. When I wear the higher heel I put more pressure on the ball of my foot and my weight is not distributed evenly. I think the nerve is involved because of the uneven distribution.

Personally, I would work to find out the cause before I would go for surgery. Make that you last resort. Maybe it's just the orthotic and you could end up in worse shape by trying to raise your joints. This sounds a little extreme.

Re: Burning Feet

Dr. David S. Wander on 5/03/01 at 08:46 (046469)

From the symptoms that you relate, it seems that your podiatrist is on the right track. There is a condition that is known as 'Morton's' neuroma, which is a benign thickening of the nerve that runs between the metatasals and branches to the toes. The most common site of this condition is between the 3rd and 4th metatarsals, with symptoms radiating to the 'ball' of the foot or 3rd/4th toes. Symptoms are often described as aching, burning, shooting pain or a cramp type pain. Patient's often complain about the feeling have having a stone in the shoe or that the sock feels rolled up. IF this is the condition, it is usually treated conservatively with pad, injections or anti-inflammatories. Surgical excision of a neuroma has lost popularity, and injections with cortisone or a series of sclerosing injections are often more popular and very successful. Undergoing any surgical procedure to fracture and elevate the metatarsals is a procedure that I personally would advise very highly AGAINST. It is a procedure with a low success rate and is rarely indicated. This procedure is also not used for neuroma pain.

The clicking or sliding you feel can be the result of the thickened nerve becoming entrapped below the ligament that attaches the metatarsals together. (The nerve is NOT being pinched between the 2 bones, since anatomically the nerve is below the bones). As your toes or foot moves the inflamed/thickened nerve can slide or press up against the ligament causing a clicking feeling or increased symptoms. This can also occur with a bursal sac between the metatarsals. My recommendation would be to stay with the podiatrist you are using, and ask him/her questions until you are satisfied.

Re: Burning Feet

HEAST on 5/30/01 at 07:51 (049321)

As a followup to my original thread. My podiatrist had my custom orthodotics recovered with leather rather than the synthetic material. That has essentially ended the burning sensation on the bottom of the ball of my feet. Too much heat build-up due to friction However, he has clinically diagnosed Morton's Neuroma (one between 3rd and 4th metatarsals, possibly one also between 2-3 metatarsals) on my left foot. I had never heard of this until this website and now have done extensive research on it. My podiatrist has a great article on his website that he wrote about Morton's. http://www.footdoctorva.com . Have recieved 3 shots into the space with no signifacnt relief. We have tentative set early Aug. as surgery date. He states he has two options for entry, the top of the foot and the bottom of my foot. Due to the heads of my metatarsals being large with not much space between them, he states he probably will do the bottom of the foot. Being a Radiology Technologist, I do recognize that yes indeed the heads of the metatarsals are large and could present some probems. Just wanted to give you follow-up on the comments in this thread and thank you. I'll provide follow-up after surgery.

Re: Burning Feet

Dr. Biehler on 5/02/01 at 11:43 (046422)

Burning and tingling in the balls of the feet can be caused by the metatarsal heads bearing too much weight. This can cause a bursitis or capsulitis. If this is the case, sometimes a metatarsal pad added to the orthotics can help distribute the presure more evenly and help resolve the problem . If the metatarsal themselves have become plantarflexed and if the pad doesn't work, it is sometimes possible to raise the heads in a surgical procedure. Dr. B.

Re: Burning Feet

Pauline on 5/02/01 at 20:33 (046445)

When I tried wearing my custom orthotics I experienced a similar feeling,
I also notice it when I try wearing a higher heeled shoe. Not spikes but
about 2'.

I attributed the burning when wearing my orthotic to excessive heat because the material didn't breath. I never got the burning without the orthotic. When I wear the higher heel I put more pressure on the ball of my foot and my weight is not distributed evenly. I think the nerve is involved because of the uneven distribution.

Personally, I would work to find out the cause before I would go for surgery. Make that you last resort. Maybe it's just the orthotic and you could end up in worse shape by trying to raise your joints. This sounds a little extreme.

Re: Burning Feet

Dr. David S. Wander on 5/03/01 at 08:46 (046469)

From the symptoms that you relate, it seems that your podiatrist is on the right track. There is a condition that is known as 'Morton's' neuroma, which is a benign thickening of the nerve that runs between the metatasals and branches to the toes. The most common site of this condition is between the 3rd and 4th metatarsals, with symptoms radiating to the 'ball' of the foot or 3rd/4th toes. Symptoms are often described as aching, burning, shooting pain or a cramp type pain. Patient's often complain about the feeling have having a stone in the shoe or that the sock feels rolled up. IF this is the condition, it is usually treated conservatively with pad, injections or anti-inflammatories. Surgical excision of a neuroma has lost popularity, and injections with cortisone or a series of sclerosing injections are often more popular and very successful. Undergoing any surgical procedure to fracture and elevate the metatarsals is a procedure that I personally would advise very highly AGAINST. It is a procedure with a low success rate and is rarely indicated. This procedure is also not used for neuroma pain.

The clicking or sliding you feel can be the result of the thickened nerve becoming entrapped below the ligament that attaches the metatarsals together. (The nerve is NOT being pinched between the 2 bones, since anatomically the nerve is below the bones). As your toes or foot moves the inflamed/thickened nerve can slide or press up against the ligament causing a clicking feeling or increased symptoms. This can also occur with a bursal sac between the metatarsals. My recommendation would be to stay with the podiatrist you are using, and ask him/her questions until you are satisfied.

Re: Burning Feet

HEAST on 5/30/01 at 07:51 (049321)

As a followup to my original thread. My podiatrist had my custom orthodotics recovered with leather rather than the synthetic material. That has essentially ended the burning sensation on the bottom of the ball of my feet. Too much heat build-up due to friction However, he has clinically diagnosed Morton's Neuroma (one between 3rd and 4th metatarsals, possibly one also between 2-3 metatarsals) on my left foot. I had never heard of this until this website and now have done extensive research on it. My podiatrist has a great article on his website that he wrote about Morton's. http://www.footdoctorva.com . Have recieved 3 shots into the space with no signifacnt relief. We have tentative set early Aug. as surgery date. He states he has two options for entry, the top of the foot and the bottom of my foot. Due to the heads of my metatarsals being large with not much space between them, he states he probably will do the bottom of the foot. Being a Radiology Technologist, I do recognize that yes indeed the heads of the metatarsals are large and could present some probems. Just wanted to give you follow-up on the comments in this thread and thank you. I'll provide follow-up after surgery.