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Feels like I am walking on hot coals.

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Hi

Recently, for the past month or so, whenever I walk for an extended period of time my feet starts to burn as if though I am walking on hot coals. The pain is in the tip of my toes and the balls of my feet. When it is not burning, I have a "over extending" pain at the joint of my toes.

The over extending I venture to say is due to me having Marfan's, but what makes your feet feel as if they are burning?

Some history:

My sister complained of the same pain when she was 18 and had to get her toes straightened surgically with pins (hammer toes I think it's called?). This is the first time I have ever had this pain instead of chondromalatial pain in my knees (I have bilatteral patella alta due to the Marfan's) and was quite alarmed when I first noticed it. My sisters operation was extreemely painfull and in the end just made her condition worse. I most certainly do not want to have to go through the same pain plus I have heard that it is ill-advised to perform ligament surgery on Marfan's patients.

Could you perhaps give some suggestions as to what kind of specialists to see and what possible treatments are availeable to patients with Marfan's?

Regards
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First Helper User Profile Gaelic
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replied January 21st, 2012
Especially eHealthy
Seraph,

As to what type of physician to see, you may want to see an orthopedic foot and ankle specialist.

Whenever a patient complains of a burning type of pain, the first thing that physicians think of is some sort of problem with the nerves. So, from your description of the pain coming on after extended weight bearing activity, and is burning in nature in the toes and balls of the feet, this could be metatarsalgia and/or Morton's neuroma.

Metatarsalgia is pain under the balls of the feet, usually after weight bearing activities, such as extended walking, running, jumping, or wearing very high heels.

Morton's neuroma causes pain and/or numbness in the toes. It is usually due to the digital nerves, which go to the toes, being compressed at the metatarsal head level.


As to having to have hammer toes corrected, that would only be necessary if you had symptomatic hammertoes, a very specific deformity of the distal interphalangeal joints of the toes. If your toes are not deformed and causing problems, then don't mess with them.

But, if you are having significant problems with your feet, see an orthopedic foot and ankle surgeon. If a foot and ankle specialist is not available in your community, see a regular orthopedic surgeon. They are also trained to take care of Marfan's patients, as Marfan's affects the bones and joints.

Good luck.
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replied January 22nd, 2012
Experienced User
Hi Gaelic,

Thank you for the great advice. My small toe do kreep underneath the toe next to it, but other than that, I don't have the physical deformity my sister has (I asked my sister to compare my toes to hers and you can actually still see the "holes" where the pins were inserted from the surgery). I will have it checked out by a foot and ankle specialist as you suggested.

I am quite thankfull that now-adays a lot more physicians and doctors are aware of Marfan's. When I was first diagnosed and you would mention the condition, they would look at you with a strange expression and say "Say what!?".

Take Care Smile
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replied January 24th, 2012
Experienced User
Hi Gaelic,

I saw a orthopedic surgeon and you were quite right. It is metatarsalgia. He says that my bio-mechancis is completely out of wack due to me having Patella-Alta in both knees as well as Fallen Arches in both feet.

He is having me fitted for orthopedic inner soles for my shoes. I also have to learn to walk properly O.O He says I roll my feet when I walk and you can see from the soles of my shoes as they are worn down on the one side.

Apart from that, he also wants me to go for an MRI as he is concerned I might be developing Dural Ectasia.

Thank you again for pointing me in the right direction
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replied January 24th, 2012
Especially eHealthy
Seraph,

No problem. Just a note on the selection of shoes.

For patients who wear their shoes out on one side and tend to roll their foot (usually pronation), they should look for certain things in shoes.

Of course, make sure that they have a good longitudinal arch support. Many good athletic shoes actually have extra pads, so that you can build up the support to exactly match your arch. If not you can get surgical foam rubber and add extra to the arch support under the shoe liner.

Make sure that the shoe has a very firm heel counter. This is where the heel of the shoe, up where it grips the back of the heel, is very firm. This can be accomplished in a couple of ways, by the way the shoe is constructed (sewing techniques) and the placement of a plastic/leather heel counter. If you take the shoe and squeeze the heel, side to side, you should not really be able to move the material very much. The shoe should cup and grasp the heel when it is put on. The heel counter keeps the patient from pronating the foot, by stabilizing the heel. This will also keep wear down to a minimum.


So, with the proper longitudinal arch support and a stout heel counter, you should note that your feet feel better and your shoes should no wear out as quickly.

Many times, surgeons can tell a lot by looking at a patient's old shoes. But, usually, patients will put on a new pair of shoes to go to the doctor's office. The surgeon would prefer the worn ones, so that he/she can look at the wear pattern, it tells so much. Oh well.


Hope the metatarsalgia pads do the trick. I've also had metatarsalgia once. Combat boots did not have very good insoles and arch supports many years ago. The new ones are great, also like wearing high top athletic shoes. But, in the olden days, they were just flat inside. After doing a bunch of road marches, I developed a great case of metatarsalgia. At that time, the guy who repaired and resoled boots on post, put in a pad designed by the orthopedic surgeon for me. I was in heaven. My feet didn't hurt after that. So, from then on, I always had special insoles made for my boots.

Good luck.
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