Persistent Pain Between Toes: Seeking Solutions for Ongoing Discomfort

Q: Persistent Pain Between Toes: Seeking Solutions for Ongoing Discomfort

Hello, Miss 0w0： Your symptoms are clinically referred to as "allodynia" and "hyperesthesia," which are manifestations of sensory hypersensitivity. <br>Clinically, in addition to physical therapy, certain medications can also help alleviate the symptoms. <br>Furthermore, suppleme

There is a sharp pain in the dorsum of the foot upon touch (which has persisted for six months)?

Hello Doctor, I used to stand for long periods at work, which often caused my feet to be very sore.
Most of the soreness and pain would return to normal after a period of rest, but the area on the dorsum of my right foot between the little toe and the ring finger continues to have a persistent sharp pain.
Even though I resigned about six months ago, the pain still persists.
When sitting or lying down without touching or applying pressure, there is no pain, but activities like putting on socks and shoes, getting water on it while showering, or covering it with a blanket trigger sharp and aching sensations.
I previously consulted a doctor and underwent prolotherapy, receiving four injections of high-concentration dextrose, but there seems to be no improvement.
This condition has lasted for over six months, and I would like to know what other medical avenues and treatment options I can pursue.

0w0, 20~29 year old female. Ask Date: 2021/07/22

Dr. Jiang Junyi reply Neurology

Hello, Miss 0w0: Your symptoms are clinically referred to as "allodynia" and "hyperesthesia," which are manifestations of sensory hypersensitivity.
Clinically, in addition to physical therapy, certain medications can also help alleviate the symptoms.
Furthermore, supplementing with vitamin B12 may have some beneficial effects.
I recommend that you consult with a neurologist (specifically one specializing in peripheral nerves) for discussion and treatment.
Please ensure to practice self-protection, maintain cleanliness and disinfection, and adhere to the new preventive health measures before and after your medical visits.
Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health and peace.
Dr.
Jiang Junyi, Taoyuan Medical Center, cares about you.

Reply Date: 2021/07/22

More Info

Persistent pain between the toes, especially when it has lasted for more than six months, can be quite distressing and may indicate an underlying issue that requires further investigation. Based on your description, it seems that the pain is localized between your right foot's little toe and the fourth toe, and it is exacerbated by contact or pressure. Here are some potential avenues for further evaluation and treatment:

1. Consultation with a Specialist:
- Podiatrist: A foot specialist can provide a thorough examination of your foot structure, gait, and any potential biomechanical issues that may be contributing to your pain. They may also assess for conditions like Morton's neuroma, which can cause pain between the toes due to nerve compression.

- Orthopedic Surgeon: If the podiatrist suspects a structural issue, they may refer you to an orthopedic surgeon specializing in foot and ankle problems for further evaluation.

2. Imaging Studies:
- X-rays: These can help rule out any fractures, dislocations, or bone spurs that might be causing your pain.

- MRI or Ultrasound: These imaging techniques can provide a more detailed view of soft tissues, including ligaments, tendons, and nerves, helping to identify any inflammation or damage.

3. Physical Therapy:
- A physical therapist can design a rehabilitation program tailored to your specific needs. They can help improve flexibility, strength, and range of motion in your foot, which may alleviate some of the discomfort.

4. Pain Management:
- Medication: Over-the-counter pain relievers like NSAIDs (e.g., ibuprofen) can help manage pain and inflammation. If these are not effective, a doctor may prescribe stronger medications.

- Injections: Corticosteroid injections can reduce inflammation and pain in the affected area. If you have already tried high-concentration glucose injections without success, this might be worth discussing with your doctor.

5. Alternative Therapies:
- Acupuncture: Some patients find relief from chronic pain through acupuncture, which may help reduce pain perception and improve function.

- Massage Therapy: Gentle massage around the affected area may help alleviate tension and improve circulation.

6. Footwear Modifications:
- Ensure that you are wearing well-fitting shoes that provide adequate support and cushioning. Avoid tight shoes that may exacerbate the pain. Custom orthotics may also be beneficial in redistributing pressure away from the painful area.

7. Lifestyle Adjustments:
- If you are still experiencing discomfort, consider modifying activities that may aggravate the pain. This might include avoiding prolonged standing or wearing shoes that put pressure on the affected area.

8. Further Investigations:
- If the pain persists despite these interventions, it may be necessary to investigate other potential causes, such as systemic conditions (e.g., arthritis or neuropathy) that could be contributing to your symptoms.

Conclusion:
Persistent pain can be complex and multifactorial, and it is essential to approach it holistically. Given that you have already undergone some treatments without improvement, seeking a second opinion or further evaluation from specialists may be beneficial. Keep a detailed record of your symptoms, including when they occur and any factors that seem to exacerbate or relieve the pain, as this information can be invaluable for your healthcare providers in diagnosing and treating your condition effectively.

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