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Why Do My Feet Hurt?


Bottom Line Personal had a Facebook chat with Dr. Johanna S. Youner, a nationally-known Park Avenue podiatrist and foot surgeon. She was the expert for our article Oh, My Aching Foot! Help for Common Causes of Foot and Leg Pain. We invited readers to submit their questions about their feet—and Dr. Youner answered those questions at

READER I had a “rash” of some sort on the top of my left foot for months and then it finally went away. But now I get what I call a “pain flashover” over the top of my foot every so often. It really does “flash” and then it goes away again. It can happen anytime of the day or night, but I can’t sleep on my stomach with my left foot flattened without pain. Any suggestions?
DR. YOUNER I would suggest you consult with a dermatologist or podiatrist to see what caused the rash. A rash like shingles can leave you painful for months afterwards. Shingles is treatable with medication.
READER The rash was not painful while it was there, but it was there for months until I finally got it to go away with St. Ives Intensive Healing Cream. Quite a while after it was gone, I started to have the pain flashovers on the top of the same foot. It seems to be going away by itself now.
DR. YOUNER You are still healing if you are getting those flashes. But I would always get a doctor’s opinion when an issue does not change on the body, like a chronic rash, a mole, a wound that doesn’t heal.
READER Why would one toenail on my left foot not grow, or grow at ¼ slower than the nail on my other big toe? It is also a little shredded and thinner than the other. I am taking an Rx cream for athletes’ foot.
DR. YOUNER A fungal nail will grow more slowly than an uninfected nail as will a nail that has been damaged. Check with your podiatrist to see if you have a fungal nail and/or other issue that can be easily treated.
READER My problem is that I suffer from pain in the left ankle since the last few years and the left foot is bending outwards and leftwards. I am flat-footed as well and have been advised to wear arched foot wear and am following it, but would like to get input from you for my problem as I am not happy with the results. Please let me know if there is a permanent solution to this problem.
DR. YOUNER Without examining you, it would be impossible to advise you on a solution. Generally, there are surgical answers to chronic foot pain such as you are having, especially if the shape of the foot is changing or flattening. I would get a consultation with a board-certified surgeon.
READER Can you suggest a solution to a hammer toe that will not include surgery—any suggestions on how to reverse a hammer toe?
DR. YOUNER There are two types of hammertoes and the answers vary. Stretching a flexible hammertoe and straightening it out a few times a day and wearing a device (the FootSmart catalog has a myriad of devices) can help. Padding the top of the toe can also help. Surgery should be your last resort.
READER I have gradually started hiking 2½ miles to a mountain summit 1,492 feet high. Sometimes the tops of my feet hurt, right above the arch. I do have high arches. I wear good socks and excellent hiking shoes. Advil relieves the pain, but I don’t want to take them. Icing helps also. Any ideas why this happens?
DR. YOUNER Higher arched feet have more problems than most foot types. An orthotic (arch support) specific to a high arch like Superfeet Green can help. If the pain becomes a daily problem, it is time to seek a consultation with a foot doctor for support and medication to alleviate the pain. Simple answers like loosening your shoelaces can go a long way as well.
READER After taking Levaquin for 2 days, I experienced shooting pain in my Achilles tendons. I discontinued the drug and had 6 months of intense physical therapy before the pain subsided. Why did this happen, and which other drugs can cause leg or foot pain as a side effect?
DR. YOUNER Levaquin is a powerful antibiotic, but this problem is appearing more frequently. Why it happens I am unsure, but avoiding this drug is the way to go. To my knowledge there are not any other medications with this problem, but that should be discussed with your doctor whenever a medication is prescribed.
READER I just had knee replacement surgery and have now developed dropfoot. I am so disappointed as the therapist has been working with me and puts on an electrode and gets no response. Do you have things I could do to get my foot back? I also have degenerative arthritis on the same foot near the ankle so that doesn’t help the situation either. Please help me to get this back.
DR. YOUNER The dropfoot may be from an injury at your knee level to a nerve. I would consult with a neurologist to see what your options are to get your strength back. There are items such as ankle foot orthoes that can assist you while you are seeking an answer.
READER I have a feeling of puffiness right behind my toes on both feet that no one, not the foot doctor nor the neurologist can figure out what is going on and I have been put on 1,800 mg of gabapentin a day. I do not want to live like this.
DR. YOUNER That is a high dose of gabapentin. I would suggest more consultations with doctors (neurologists/podiatrists/internists) that think outside the box. The puffiness could be from chronic lymphedema (swelling) for which wearing support socks/stockings helps. It there is pain involved, one needs to get to the root of the pain (back disc? arthritis?). More heads need to be involved to help you out. If it is a local foot problem like an inflamed neuroma (nerve between toes 3 and 4), treatments can involve radio frequencies to knock out the nerve pain, sclerosing injections to shrink. You need a diagnosis first. Don’t give up—everything has an answer, or a least a better solution than being on that may pills.
READER I have been an avid backpacker for about 20 years—on and off trail, one week to one month trips. In recent years I have been having blister problems. I have tried different boots, different socks, different preventative taping, and lighter loads, but nothing seems to work. A simple weekend backpack trip can result in very large blisters. I’m beginning to think that so many years of backpacking have taken a toll on my feet, causing them to become hyper-sensitive. Are my backpacking days over?
DR. YOUNER I would seek a consultation with your doctor to see what has changed and how to help you. It may be a simple answer, but it needs to be evaluated to get you that answer.
READER Why do the bottoms of my feet disintegrate without rubbing them every day with good foot cream? I have cancer of the blood plasma (multiple myeloma) and am on chemo for that. I have been on chemo for 3 years now. No one can tell me if my foot problem is related to the cancer. I am thinking it is, but perhaps there is a more common cause and/or perhaps there is a therapy I could be utilizing. My toes fold over, also. This started before the cancer, but has gotten much worse. I should let you know that when I was younger, I ran 15 marathons and, of course, all of the running that went along with that.
DR. YOUNER Chemotherapy may cause a foot syndrome that makes the feet extremely sensitive, painful, and easily infected, blistered, etc. Please let your oncologist refer you to a podiatrist well versed in the side effect of chemo called “Palmer Plantar Erythrodysesthesia.” This may be part of the problem.
READER Had my toenail removed and phenol ablation performed 3 weeks ago. I have been on antibiotics, course of pulse steroids, Epsom salt foot soak once a day, and bandage cover (now without antibiotic cream). Still some small leakage from near the cuticle, and it looks like that cuticle is continuing to recede back further. Does not look infected, but I’m worried about this tissue receding and when/if it will stop. Is this abnormal and will it become disfiguring? Anything I can do to get it healed up quicker? Any input would be much appreciated.
DR. YOUNER This is a normal side effect of a P and A. A nail takes 12 months to actually grow normal from cuticle to tip. I like AMERIGEL for speeding up P and A healing—available without a prescription at your pharmacy.
READER All my toes hurt mostly all the time and some of the pain medicine does not work, but when my feet are warm, they do not hurt. What could be the cause of this?
DR. YOUNER Without examining you, a diagnosis isn’t possible, but there are conditions like cyoglobulinemia where the toes get cold and create problems. Please see your foot doctor to be evaluated.
READER Any way to fend off posterior tibial tendinitis when it starts to take hold?
DR. YOUNER Good arch supports and Aleve, twice a day with food.
READER I have a torn meniscus on the left knee—can ultrasound therapy help heal this? I also have a bad neuroma on the second toe of my left foot. Shots had helped, but not anymore. Will surgery correct this or is it a 50/50 chance of cure?
DR. YOUNER Surgery can correct a neuroma easily. I’m not familiar with knees so I would refer that question to an orthopedist.
READER I have a pain in my heel. It’s like a burning sensation. It’s not on the bottom of foot though, it’s on the inner side of the left heel. I do have a cyst in my lower back and it’s on the left side. Do you have any insight?
DR. YOUNER Sounds like plantar fasciitis, which is an inflammation of the arch. Icing the area, stretching the Achilles and wearing supportive shoes (not flip-flops) will go a long way to helping your pain. If this simple treatment does not help, see your podiatrist.
READER I came close to getting frostbite in 1989 doing farm work in 18 degree weather. Now my feet are numb and sometimes they hurt. At least my toes hurt. Why should this be only some of the time and how can I make them stop hurting. I can’t sleep when they hurt.
DR. YOUNER Chronic pain from frostbite is well served by antidepressant pills like Cymbalta and Zoloft. I would consult a pain specialist. There are topical pain creams that are customized these days—also a good choice if you don’t want to take pills.
READER I am worried about the pain in my feet for the past 2 years. It’s somewhat debilitating and some of it may be due to arthritis. I find orthotics hurt and have been told it’s like being in a cast whereby the feet are not exercised.
DR. YOUNER Not all orthotics are the same. You may be helped by softer Plastazote inserts (available at most podiatrists for less than $30). Orthotics are great for most people, and the ones available in specialty stores by brands like Allmed and Lyncos may help you a lot.
READER I had a car run over my feet when I was in my early 20s and the injury I received from that was a chip fracture of my left lateral malleolus on the right foot and a few abrasions on both ankles. It is weaker than the left one, which I expected—if I sprain the ankle it is always that one. They couldn’t put a cast on it because I also had severe lacerations down to the bone on the actual ankle and a large wound about 3″ above that one. They had to remove almost all the flesh at the back of the foot because it was full of road grit. It healed from that except for a mild summer swelling of the ankles which, last summer finally seemed to have gone, but this year I have had localized swelling on both ankles, and the lower leg of the ‘bad’ foot. The uninjured one has an egg sized lump on the outer ankle, and the other one has a swollen lump from where the ankle narrows to the part where the calf begins to fill out the leg’s silhouette—nowhere else and only on that side that was injured. Unlike ‘summer swelling’, which has been very pronounced this year on that side and nowhere else. It doesn’t go down at night, and the skin feels different on the swollen part, colder somehow and clammy, there is no discoloration, but the area is tender to the touch. My GP believes it is water retention and, as he suggested, I exercised the ankle, but all it does is remove the ‘summer swelling’ not the other thing. It has been on my leg for over six months now with no apparent change, and it doesn’t seem to have any effect on my movement though both ankles are so loose I can clap my feet the same way I can my hands. That never changed since before I was run over, but these lumps?
DR. YOUNER You may have severely injured the soft tissue in your ankles. An orthopedic surgeon (or a podiatrist if your state allows ankle surgery for podiatrists) can repair the ligaments. Get a consultation with a foot specialist to get help.
READER My feet hurt when I get up after sitting even 15 minutes.
DR. YOUNER If you have inflammation like plantar fasciitis or heel pain, your feet start to swell and hurt when you get back up. Arch supports, good sneakers during the day, and Aleve when it is painful help, but get evaluated to see what is going on in general.
Date: August 21, 2013 Publication: Bottom Line Personal
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