Ask an expert

08 Jan 2005

worrying over pain in foot and running (pinched nerve?)
Can you please tell me how I would know if the pain in my foot is morton's neuroma or a stress fracture? It neither swollen, nor red, nor can i feel a hardening.
It's location is on the outside of my left foot's last metatarsal bone. I run about 28Km a week, but I first noticed this pain during an off day. I wore sandals and walked quite a bit doing shopping. It is a sharpish pain that is relieved by rest, ice and walking barefoot.

Can I run with it??? Or should I rather go to a dr? I don't want to rest from running, as I do NOT want to lose any fitness. But i also don't want to cause permanent damage to my foot.
What if i only take anti inflammatories and scale down the ammount of running i do...from 28 km per week to, say, 20? or 16 even?
HELP as i neither want to lose my running nor my foot!
I NEED to run. I would go crazy and fat if I can't run.

Sorry that this is getting to be very long. But here's the final thing: two years ago I torn my left ankle's outside ligament, and had reconstructive surgery done. Could this be the cause of my current dilemma perhaps?
(I didn't have any problems with my ankle since)
Should I maybe go to the orthopoedic surgeon who did the op? Or to a gp? Or not at all?
Thanks for your time and attention.
Answer 355 views

01 Jan 0001

Hi Worrywart

It's quite difficult to say whether the cause is either one of these, or perhaps neither. Certainly both are possible. With stress fractures, the symptoms include in an inability to put weight on the foot, swelling, and more severe pain. The acute pain seems consistent with your problem. one of the treatments for such a fracture is to wear stiff soled shoes, so, working backwards, it may be that your day of wearing sandals was not good and this could have contributed to your pain, if the stress fracture was there already. What you have to remember though is that a stress fracture develops over a fairly long time period, and requires some sort of predisposing factor, like increasing your training too quickly, or maybe flat feet. Therefore, the history of your training is quite important. one other very important symptom is that there is often some swelling and it will be quite tender to touch, and it does not seem that you have this problem, which suggests maybe it is not a stress fracture. Again, however, remember that you rarely have the exact 'textbook' injury with all the symptoms so that's by no means a definite confirmation.

Morton's neuroma causes slightly different symptoms though, and in my admittedly limited medical opinion, I would be surprised if this was your problem. First the pain is between the third and fourth toes, you describe yours as being outside the last metatarsal. There would also be pain on palpation, something I'm not sure you have. Also the pain is worsened by walking, and you say that walking barefoot is actually relieving, so that is another contradiction.

The only way to get an definitive diagnosis is to see a doctor. I think that this is the best thing for you right away. Stress fractures are diagnosed with an MRI, which is really the only definitive way. However ,a good doctor will take steps to avoid this, and by examining your training history, they will be able to eliminate any other possible causes. My suggestion is that you go to a sports medicine specialist. You may need a referral from a GP, I am not sure.

Finally, in the meantime, I am not sure whether you have alternative exercises at your disposal. You can cycle, or swim, now that it is summer time. I suggest trying these, but don't panic, often it only takes a short break and I really don't think that you will become as unfit as you think.

Good luck
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical examination, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.
Voting Booth
Have you entered our Health of the Nation survey?
Please select an option Oops! Something went wrong, please try again later.
33% - 9321 votes
67% - 18660 votes