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New to foot problems, question re diagnosis

Posted by A Clark on 1/24/02 at 23:50 (071194)

Hello

I'm a 50 yr old female with recent onset of foot pain. Have ongoing lower back problem from injury in 1998. In recent months have developed foot problem which are; pain under 2nd 3rd and 4th toes of right foot, pain in arch of right foot, general tight painful feeling in soles of both feet, small numb area on inside of left foot near heel, shin pain at night, pain worse after getting up from sitting down and in the mornings, feet often feel hot when painful, and lastly but most painful is pain in the ball of my right foot. I saw a podiatrist who diagnosed PF and now have orthotic inserts for my shoes, just started on them today. My Dr ordered an X ray of right foot which showed a tiny plantar spur and osteoarthritis in the big toe. My questions are;

1 Is PF different from a plantar spur, I've tried to work this out from reading the messages but no luck. Does a spur lead to PF, or can PF be independent of a spur or what?
2 People speak of heel pain and heel spur, my pain is predominatly in the ball of my right foot, it feels like theres a stone in there, I dont get heel pain, so if PF is heel spur, wouldnt I get heel pain?

3 I also have capsulitis in the second and third toes of my right foot, any comments?

4 I feel that all this could be related to my back problem, which is at
L4/5 level, although I suspect that something has happened at a lower level in my back, as I got pain in the lower area about the same time as the foot problem started. If anyone can assist me with clarification about whether heel spur is PF and if so why I have pain more in ball of foot, I would be much obliged, sorry about this lenghty missive.

Many thanks for your time and ideas

Anne

Re: New to foot problems, question re diagnosis

Al K DPM on 1/25/02 at 05:03 (071206)

What you describe is classic inflammation along the forefoot or 'ball of the foot' that can result from compensation, due to other things, plantar fasciitis. Heel spur and Heel pain are not synonymous. Many people have heel spurs, and not heel pain. The plantar fascia originates along the heel and fans out into many 'slips' along the ball of the foot. Sometimes, this fascial pain can extend along the slips in the ball of the foot. I have used the term capsulitis for pain in the ball of the foot, but remember, pain in the ball of the foot can be the result of a number of problems. I think anytime time there is warmth and associated swelling to the ball of the foot, it is usually related to inflammation along the plantar metatarsal heads and its associated structures (ie plantar plate, ligaments, etc). This is usually related to stressed dorsflexion of these joints. If you feel like there is a stone in the ball of the foot, your joints may be subluxed or dislocated, which is an entity all in itself. Back pain can cause many compensatory changes in the foot, that can also lead to some of the problems you described.
Al Kline DPM See us on the web at: http://www.podassociates.net

Re: New to foot problems, question re diagnosis

Al K DPM on 1/25/02 at 05:03 (071206)

What you describe is classic inflammation along the forefoot or 'ball of the foot' that can result from compensation, due to other things, plantar fasciitis. Heel spur and Heel pain are not synonymous. Many people have heel spurs, and not heel pain. The plantar fascia originates along the heel and fans out into many 'slips' along the ball of the foot. Sometimes, this fascial pain can extend along the slips in the ball of the foot. I have used the term capsulitis for pain in the ball of the foot, but remember, pain in the ball of the foot can be the result of a number of problems. I think anytime time there is warmth and associated swelling to the ball of the foot, it is usually related to inflammation along the plantar metatarsal heads and its associated structures (ie plantar plate, ligaments, etc). This is usually related to stressed dorsflexion of these joints. If you feel like there is a stone in the ball of the foot, your joints may be subluxed or dislocated, which is an entity all in itself. Back pain can cause many compensatory changes in the foot, that can also lead to some of the problems you described.
Al Kline DPM See us on the web at: http://www.podassociates.net