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Sharp pain on top side of one foot over two little toes when walking

Posted , 3 users are following.

audrey80537
audrey80537

This sharp pain came on suddenly several days ago.  Went to my primary doctor and she sent me for an X-Ray which showed no fracture.  Monday she wants me to have a CT scan.  On the first day the pain was sharp after a few steps and now resting as much as possible  I only have the stabbing pain late in the day.  

Have had PMR for 18 mos and at 13 mg prednisone having had several flares. Could  this foot issue possibly be caused from the PMR.  I am also experiencing discomfort in my lower back.

aside from skin issues I have not experienced any side effects from the prednizone.  Also, I am not overweight.

0 likes, 6 replies

6 Replies

  • EileenH
    EileenH audrey80537

    Posted

    I had strange pains in my feet at various times - it was probably synovitis/tendonitis as part of the PMR at the beginning, pre-pred. I did notice that if I trod awkwardly I sometimes would get sharp pains above my toes but I think I always put it down to the tendons being a bit delicate as a result of pred. Even if I had gone to the doctor I doubt I'd have been sent for an x-ray and certainly not for a CT - not in the UK - so I have no concrete evidence! It always resolved after a few days so I never thought any more about it.

    Your low back problem is possibly something that is fairly common in PMR - and very often caused by something called myofascial pain syndrome. It is caused by the same inflammatory substances that cause PMR except they are localised in the fascia (the thin skin covering a muscle) and in muscle fibres. The latter cause hard knots to form in the large muscles, in pairs on either side of the spine, in the shoulders, about rib level and in the low back. These knots of inflamed muscle fibres put strain on the rest of the muscle and can cause it to spasm - which in itself causes pain. Both aspects can also lead to irritation of nearby nerves which then can lead to referred pain in the relevant places - neck and upper arms, the rib area or the low back and thighs, it is one cause of sciatica. Mine tends to take the form of sacroiliacitis, inflammation of the sacroiliac joints in the pelvis.

    It is possible that your foot problem MAY stem from the low back problem. I found something called Bowen therapy helped a lot with my back problems and I'm not the only one on the forums with a similar experience. Google Bowen4life to get a lot of information about it. The podiatrist who writes there used it for his patients with other problems who later reported great improvement in foot-related problems. PMR definitely affects our posture and how we walk - my chiropodist always comments on how much better my feet are now the back and PMR problems are much improved. Google Bowen directory to get a list of practitioners where you live.

    I not only used Bowen - a good physio and the pain specialist both did manual mobilisation of the trigger points and I have also had a technique which is called needling in the USA - the combination worked miracles over a few months. I ended up in hospital with back spasms and their first-line approach caused a severe drug reaction so I was handed over to the pain clinic for the slower version. I had this needling technique as well as steroid shots in the trigger points and spasmed muscles as well as the manual mobilisation - there was very little physio as such as the PMR made that difficult and unadvisable.

    • audrey80537
      audrey80537 EileenH

      Posted

      Hi Eileen and thanks for responding.

      i have tried Bowen in the past for other issues and I did not have good results.  Went three times and nothing positive happened, in fact, one time upon leaving I could barely walk. Maybe

    • audrey80537
      audrey80537

      Posted

      oops!

      maybe it was me or the therapist, I don't really know but she is the only one around.

      when you say needling is that what we call accupuncture because that's my next step.

      i wanted to know what you thought 

    • audrey80537
      audrey80537

      Posted

      also wanted to get your opinion about increasing pred to maybe 18 for a few days to see if the foot and back pain is relieved.  If I were to do that and there is no difference cand I just lower back to 13 over a week?
    • EileenH
      EileenH audrey80537

      Posted

      No, not really like acupuncture, although googling dry needling brings up a very interesting article in wiki which links them - have a look rather than me writing about it.

      Mine was done here by an anaesthetist who is a pain specialist and I'd had it previously done by my GP in Germany. They both used normal but fine hypodermic needles - but they probably technically didn't do dry needling, you can also use corticosteroids, muscle relaxants and even just saline. I find it burns exquisitely as the needle goes in, just for seconds. So I gather do most others! Squeals are often to be heard from outside! Acupuncture doesn't hurt does it? I've never tried it. But there is certainly a similarity in the hollow needles used.

      As for increasing the pred - if it is tendonitis I doubt a bit extra for a few days would make much difference. My foot problems took months to fade at that sort of level - tendons have poor blood supply so it takes a long time.  I suppose there is no reason why you couldn't take 18 for a few days to see and go straight back to 13 over a couple of days. It shouldn't be a problem if the 13mg is managing the rest of the PMR in the meantime. 

      Generally massage isn't recommended in PMR - it can make it feel as if you are having a flare because it releases the inflammatory substances into your system. Even Bowen can leave you feeling rubbish for a similar reason. But if you are expecting it you don't panic about it - and there are several of us on the forums who DO use massage and find it helps once the whole thing has calmed down. A good physio might be the place to go for some advice about the low back pain. The orthopod I saw here told me I'd have to put up with the low back pain, it was wear and tear. Both the pain specialist and the physio at the hospital just rolled their eyes! It was very obvious from a physcial exam that the back muscles were in spasm and as hard as boards - hence the pain and posture - affecting all sorts of things.

    • Anhaga
      Anhaga audrey80537

      Posted

      I've had dry needling to alleviate spasmed back muscles,  (I didn't even know they were so tight), and it did help a variety of problems like painful hip.  It was definitely dry needling - I asked my physiotherapist after the conversations on here where mention was made of sosmething being injected.  Sometimes it feels like a finger being pushed into my flesh, as it triggers some sort of electrical thing.  And it can be painful, but only momentarily.  In the past I've had acupuncture, not for PMR, and it helped with repetitive strain caused by my work.  I haven't actually heard of anyone who found acupuncture helped with PMR as such, but worth trying for other issues.
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