Monday, March 23, 2009 emma, Community Member, asks

Q: pain in toes when walking

i have pain in my small toe and the one next to it, when i walk its like a shock through the toes.i think i also have a bunion on my other foot

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Answers (2)
theresa, Community Member
3/24/09 8:57am

I have had RA for over 4 years. For the past 25 years I have had foot problems such as sprains, plantar facitis, bunions corns...

 

I recently went to my podiatrist after experiencing nearly immobilizing foot pain after spending 5 enjoyable hours walking around NYC (I was wearing flat shoes with my custom orthotics). After the walk we had dinner...when we got up to leave the resaurant...yow...did it hurt! Since I thought that I had injured my foot from overwork, I went to the podiatrist instead of my Rhuematolgist. It took me nearly a month to get into my appointment.

 

The pain I was experiencing was in the two toes next to the big toe. The doctor noted that I had the beginning of a bunion just below the big toe. He is a really good doctor who likes to thoroughly explain everything. He told me that a bunion is not a growth on the bone, but a shifting of bones in the foot...he drew sketches of the correct allignment of the bones in the foot and of the deformation caused by a bunion. He explained how body weight energy is transferred during walking. He drew me a picture of a footprint in the sand and noted that the footfall starts at the heel, energy is directed along the outside of the foot to the toes and the energy exits out of the big toe. when a bunion forms, the bones in the big toe are misalligned and the energy seeks a different path...hence I am experiencing pain in the two toes adjoining the big toe.

 

The podiatrist sent me for an MRI to determine if I might have a stress fracture and to determine if I was starting to develop capsilitis in the joints of my toes. The MRI ruled out a stress fracture and confirmed the development of capsilitis. It also identified a possible rheumatiod nodule. Since the pain was limiting how much time I spend on my feet I opted to have a cortisone injection in lieu of physical therapy. I have also set up an appointment with my Rhuematologist...they scheduled me in quick since I had the MRI (I'll wait only 4 days instead of 2 months for my appointment).

 

I am optimistic that the Rhuematologist will work out a game plan for dealing with the RA related issues that are developing in my feet.

 

 

 

 

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theresa, Community Member
3/31/09 1:30pm

This is a follow-up from my last post. I saw my Rhuematologist last week. In addition to the nodule (which I will have biopsied to confirm that it is a nodule and nothing else) and the capsulitis, I have (a) Morton Nueroma. It is an inflammation around the nerve between toes 3 and 4. My RA doctor said to try a simple solution...no high heels with pointy toes! Wear shoes that give the toes room to breathe and not compact. Look for square, wide toe shoes or sneakers. To reduce pressure in that part of the foot, heels should be wide or wedge-like with a maximum height of 1 1/2". Both the Morton Neuroma and the capsulitis will benefit from shoes taht do not 'overwork' and flex the toes...look for a sole that is firm but not rigid. Also, shoes that cover most or all of the instep will reduce strain on the toes. My feet are feeling better with lower shoes...I'll keep looking for the ideal pair.

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By emma, Community Member— Last Modified: 02/03/14, First Published: 03/23/09