A 45-year-old female presented at Leading Edge Podiatry with pain in the balls of her feet. She reported that the pain had been present for approximately 18 months and had gradually worsened over time. She had a history of wearing high-heeled shoes, which she believed was the original cause of her pain.
Patient’s Pain Symptoms
The patient reported that the pain was present in the balls of her feet. The onset of pain was when she first noticed a sharp stabbing-like pain near her toes when wearing tight shoes. Sometimes there was also a dull ache or burning sensation in her feet. The pain was initially mild but gradually worsened over time. The pain was worst when walking and standing for prolonged periods. She noticed the pain would reduce after she took off her shoes. In more recent times, she would notice the pain even when not wearing any tight shoes.
Examination and Assessment
The podiatrist carried out a thorough examination, beginning with a comprehensive history-taking. The patient’s feet were examined and palpated; the pain was worst when pressing on the balls of the feet and squeezing around the toes. The pain was greatest around the 3rd and 4th toes but could shoot up to the balls of the feet.
Diagnosis and Treatment
The podiatrist diagnosed the patient with Morton’s neuroma with bursitis. The patient was advised to avoid wearing high heels and tight shoes and recommended to wear shoes with a wider toe box and more cushioning. Foot mobilisation and dry needling were also performed to loosen the joints in the feet. The patient was advised to wear orthotics to support the arch of the foot and to reduce the strain on the ball of the foot with metatarsal padding.
After 6 weeks of treatment, the patient reported a significant reduction in pain and was able to walk and stand for prolonged periods without discomfort. The patient was advised that high heels can trigger the pain again and should only be worn for short outings or events where she is not standing or walking for prolonged periods.
