Dance Away On Your Wedding Day
I recently saw a patient that was young, healthy, and a new bride. She came into the office with a complaint of severe pain in both of her feet. She had no bunions or hammertoes, just severe pain in her feet and toes. I asked when the wedding was and she replied that it was just two days ago, and that she would be leaving for her honeymoon the next day.
She explained she wore high heels with her wedding gown, and when I asked her to describe them to me she took out her smart phone and showed me a picture. The shoes came to a sharp point at the toes, with a very low toe box. In addition, the shoes had four inch heels which forced all of her weight onto the balls of her feet. I asked her if she danced, and she responded that of course she did, it was her wedding day. Not the smartest question on my part, but what I meant to ask was if she danced in those shoes or in another pair. She danced in the high heels and was having weird pains in [her] 3rd and 4th toes which went from cramps to sharp shooting pains, and [she] felt a popping sensation.
Digital X-rays were negative for any problems to the bones. I asked her to stand barefoot for me and the first thing I saw was a space between the 3rd and 4th toes which was greater when compared to the spaces between her other toes. When she sat back down, I pressed down in what we call the third interspace and she pulled her leg back from the pain. Ok, now I was getting a better picture of what was causing her pain. Next, I squeezed her foot from the sides while pressing on the bottom of the foot and she heard and felt a pop, just like I had when dancing. This maneuver is called a Moulders Sign which is a simple diagnostic test for a condition called Mortons Neuroma. The final diagnosis was made by performing a Diagnostic Ultrasound in the office. The ultrasound showed a distinct mass between the long bones in her feet which was the Neuroma.
I explained that it was an extremely inflamed nerve which was a branch of the plantar nerve. Is it cancer? I know anything that ends in OMA means tumor she asked. I quickly calmed her fears by telling her it was a benign nerve entrapment that can causes a lot of pain. Ok, so what do we do now? Im leaving for Europe in the morning and I dont think my husband wants to spend the trip rubbing my feet.
I advised her of all treatment options from anti-inflammatory drugs, padding, orthotics, cushioned wider shoes, cortisone injections and surgery. Being very sensible she said, let’s try the injections, orthotics and padding with the pills to reduce the inflammation and Ill wear more sensible shoes. Treatments were given, and the patient walked out with a smile because the injections worked right away.
About 2 weeks later I get a post card from Lisbon with her thanks. She said that she was walking on cobbled stone streets without pain and my husband didnt have to rub my feet once. Thanks Dr. Bowman. You saved my honeymoon!
If you suffer from any pain to your feet or ankles or need shoe advice for a special occasion give Dr. Jeff Bowman of Houston Foot Specialists a call at 713-467-8886 or online appointments are available at www.houstonfootspecialists.com. Same day appointments are available in most cases.
Category: Foot Pain
Tags: Bunions, foot pain, Footwear, Hammertoes, High Heels, Morton's Neuroma, Nerve Problems, Orthotics, Toe Pain, Women's Shoes