Hi all, I badly need some help.
I'm a GP myself, and am unsure where to go from here. I've had pain in the metatarsal heads region bilaterally for about 7 months now. It started off in my left foot when I was running a lot, gradually progressed to the point where I could hardly walk. The pain was sharp, in the ball of my foot and occured on lifting off the ground. I was tender over the distal metatarsal shafts. I saw an orthopaedic surgeon and a physio at the time, the consensus was I either had a metatarsal stress fracture or was about to have one, and we elected not to get any imaging as the treatment was the same regardless - just rest it. I wore a cam boot for a month, during which time I started to get the exact same symptoms in the right foot - just from walking around at work.
The physio made me orthotics with metatarsal domes which worked up to a point - they relieved the pain initially, but when I started trying to walk a bit more (and I don't mean much - like parking at the far end of the car park rather than at the front door of the supermarket) it all flared up again.
So I saw another physio, on the recommendation of a friend. His assessment was that my plantar fascia was extremely tight, and set about releasing it. I ditched the metatarsal domes at this stage. I rolled my foot on a golf ball every night with great relief. Over about 2 months things greatly improved to the point where I could walk around normally.
Things went pear-shaped when I tried running again - gentle runs, on flat grass, no more than two or three laps of a football field. Each time I've tried it's caused a flare and I've had to cease all activity.
My last attempt at running was 2 weeks ago, and since then the soft tissues over the plantar fascia have been really swollen and tender, which has never happend before in all of this. The golf ball, which before had nightly relieved my pain, now made things worse. I went back to the physio who did his usual manual stretching and massage, and instead of improving things it's made the inflammation worse. I have a dull burning sensation in my plantar fascia at night, and pain and a crackling sensation in the ball of my foot whenever I lift off the ground.
I'm at the end of my tether. I'm in my 30s and can barely walk. To me the whole thing seems like a mechanical problem, but I'm uncertain as to the exact diagnosis - everything I've read suggests plantar fasciitis causes heel, not metatarsal head, pain; and reliable information on metatarsalgia is hard to find.
I haven't gotten expert help sooner as I know I don't need an operation, and am reluctant to have a steroid injection, so what's an orthopod going to do for me? But I've realised I'm my own worst enemy and have booked an appointment. But any advice as to what might be going on or what I can do in the next month while I'm waiting to see them would be greatly appreciated.