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metatarsalgia or achilles tendonitis - which to treat first?

Posted by HelenEC on 7/21/04 at 18:23 (156010)

Around Xmas I started with metatarsalgia. Looked it up, 'unsuitable shoewear' listed as #1 cause. Looked at my new pointy toe boots and thought OK.... Switch to round toes didn't help, gradually lowered heels to flat boots (then in fashion) and suddenly - bang - I have heel pain. I need heels to stop the heel pain, but wearing any kind of heel brings back the metatarsalgia. They have got to be connected, haven't they? Can I treat this with stretching and over the counter orthotics (I have thing that looks like a slug intented to support the toes, as well as arch/heel lifts) or do I need a podiatrist?

Helen

Re: metatarsalgia or achilles tendonitis - which to treat first?

Ed Davis, DPM on 7/22/04 at 22:44 (156089)

Helen:
Unfortunately, the term 'metatarsalgia' is not a specific diagnosis; it just means 'pain in the metatarsal area' which can be a lot of different things so getting a more specifc diagnosis would help a lot.
Ed

Re: metatarsalgia or achilles tendonitis - which to treat first?

HelenEC on 7/23/04 at 17:11 (156152)

Thanks, I appreciate you replying.

My greek is good enough to note that 'metatarsalgia' just means 'a pain in the toe'. This was a pain in the 'pads' of the third and fourth toe on the left foot only when high heels were worn. I'm not a constant high heel wearer - indeed, I grew up mostly barefoot and still prefer barefoot provided I'm not walking on a stone floor or similar. I'm 46, work in an office but not at a desk all day, have no sporting habits, and haven't seriously changed lifestyle over the period of the symptoms. My toes have a wide spread with no natural deformities. I therefore put the initial cause of the pain down to new footwear that was unsuitable for daily wear.

The problem I have is that the pain did not subside on going back to my normal footwear, but has continued to be an issue for over six months unless I wear shoes with a hard flat sole. Unfortunately, doing this resulted in heel pain which has become progressively worse.

I could cure the heel pain by wearing shoes with a low heel, but the toe pain returns. I therefore think the toe pain is the underlying issue, but other than 'unsuitable shoes', muscular-skeletal deformity or mechanical defect, or neuropathy, I can find no other explanation in the literature for metatarsalgia of the type I have suffered. According to everything I have read, since the kind of to pain with no external damage caused by wearing Manolo Blahniks does not arise from injured muscles/ligaments, it should have gone away when I dumped the shoes.

Hence the question. I have concentrated on the heel because it hurts, but should I really be seeing a podiatrist about the toe, and what might cause that kind of symptom so long after any initial damage.

Re: metatarsalgia or achilles tendonitis - which to treat first?

Darlene on 7/23/04 at 18:05 (156154)

Helen:

I am not a doctor. It could be a Morton's neuroma. Pain between the 3rd and 4th toes at the ball of the foot. Orthotics with a good metatarsal pad could help to take the pressure off of the painful area.

Darlene

Re: metatarsalgia or achilles tendonitis - which to treat first?

HelenEC on 7/25/04 at 03:48 (156221)

It's the right toes, but the initial pain was in the pads of the toes, right at the tips. I though at first it was chillblains, and kept looking for them, it was that specific.

However, having read round *this* site, I'm more inclined to think it might be. My GP was kind of dismissive - 'oh take some painkillers and don't wear those shoes again and it will be all right' - but I don't think it ever was!

Helen

Re: metatarsalgia or achilles tendonitis - which to treat first?

HelenEC on 7/25/04 at 06:44 (156224)

The thing that makes me think it is not Mortons is that I can wear wooden shoes (you know, the Dr Scholl type thingies) without discomfort, but I can't wear any kind of heel. The pain is definitely right in the tips of the toes - I thought Mortons was in the ball of the foot.

Helen