Question – foot pain and numbness in the 4th toe
"Please can you help with my foot pain. I have been running for years and after a recent skiing trip I tried to run and started with acute pain in the middle side of my right foot. This then progressed to pain at the top base of my fourth and fifth toes which is very painful if I try to turn my right foot to the left. the pain is also accompanied by numbness in my fourth toe on occasions. This pain has lasted for five weeks now and even after rest, ice, heat, and anti-inflammatory medication nothing has changed. The pain is worse at night but does not hurt me when I am weight bearing. It seems worse when my foot is off the ground. The foot can be moved around and there is no redness or swelling."
A diagnosis based on such limited information is difficult. I recommend you consult someone about your problem – GP, physio, podiatrist. Do not just rely on my help.
So what is going on? Difficult to say without examination/x-rays/MRI. It might be Morton’s Neuroma, which is irritation of the common digital nerve causing thickening of the nerve sheath. What else could it be? Stress fracture, arthritic/degenerative changes, capsulitis, bursitis … and more.
Morton’s Neuroma? However you say that rest, ice and anti-inflammatory meds have not helped. And strangest of all is that you have no pain when you are weight bearing, and you have no swelling or redness. But you do have numbness and your ski boots might have been too narrow for you and put pressure on the nerve. Morton’s Neuroma often produces sharp, stabbing, burning pain, and numbness which is often located around the 3rd/4th toes. The pain can radiate to the ends of the toes and even up the legs. The pain is often relieved by removing the shoe and is more common in women because of shoe choice (high heels/tight shoes across the front of the foot), and those with flat feet. Treatment: rest, ice, elevation, anti-inflammatory meds, taping, padding, supportive comfortable shoes, orthotics with a metatarsal pad to spread the metatarsal bones. I suggest an x-ray to rule out a stress fracture, orthotics/arch supports and most important of all a metatarsal pad to spread the metatarsals. Get some thick chiropody felt and stick it to your foot as below. It is better to stick it more towards the arch than putting it anywhere near the problem area. If you put the felt on top of the painful area it will make your pain worse. And lay off the running. If things don’t improve soon you should ask your doctor for an MRI scan.