Orthotics for foot pain

Andy writes:

<<I am getting a sharp nerve pain on the top of my left foot that feels like my shoes are too tight. The pain is between my big toe and 2nd toe and it hurts to touch the area between these toes on the top of my foot (i followed it up my foot and it goes back into my ankle). there is a place on left hip that is pretty tender too (I noticed it when trying to stretch out the pain) and if i rub certain areas of my left hip i can almost feel it in the same place on my foot, but very faintly. The pain is only on the top of my foot - i have prodded excessively all over the bottom and sides of my feet. It is not there on the right foot at all.

I have flat feet and have been snowboarding recently (which requires alot of pressure on top of my foot from bindings which clamp down and i guess further flatten the sole of your feet).My boots do not have very good arch support.
I also can bring on the pain when in my boots / bindings and I try and lift the toes of my foot against the boot.

A friend lent me his orthodics which are very pronounced and i had a pain free day from this condition - including a pain free day snowboarding. The only thing is they may be too high for me because they made the soles of my feet ache in a fatigued sort of way, but maybe i need to develop the muscles in my feet more.

I am wondering what is wrong with me. I think i have a Midtarsal fault from what i read on the internet.

is there any point stretching / strengthening? (how might i do this)

Thanks in advance for any light you can shed on this pain. The closest podiatrist is over 90 kms away.>>

Hi Andy,

You may very well have a midtarsal fault because typically in this condition there can be irritation of one of the superficail nerves that runs directly between the first and second toe, so irritation to that nerve further back on the top of the foot could cause pain, or at least an annoying discomfort in between the first and second toes.

Secondly, the reason you may have a midtarsal fault is because you state that wearing a friend’s orthotics alleviated the pain.

The problem is that the arch on that particular orthotic was too high as it irritated the bottom of your feet.  So… one thing you could try would be to purchase an over the counter orthotic in a local store or buy one on line that has less of an arch support.  It should help alleviate your problem while not irritating the bottom of the foot.

If however, this does not work out for you, then you would be forced to see a doctor.

Good luck.

Marc Mitnick DPM

Title: Health Tip: Why Do My Muscles Twitch?
Category: Health News
Created: 7/28/2009 7:00:00 AM
Last Editorial Review: 7/28/2009

Not often, but on occasion people will come into the office with a chief complaint of an uncontrollable twitch in their foot or one of the muscles in their leg.  Most of the causes for this twitch are innocuous and will diminish over time.  Read more