To be mystified about foot pain and all the possible reasons for it?

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I’m reasonably medically literate but so confused. My issues are as follows:
-Pain in both big toe joints, worse on one side, very painful if I bend them when weight bearing. There’s a loss of range but not fully.
-My feet are very painful in the ball area and generally very achy after walking/ standing.
-I have had custom orthoses made by a specialist shoe shop, these can feel like a relief initially but when I wear them a lot the pain just continues. I don’t think I have fallen arches and at rest my arches look fine.
-I have no heel pain.
-I am a healthy weight (just over 8 stone).
-I’m mid 40s
-Perimenopausal and on HRT

Everything I’m reading seems to say plantar fasciitis but I don’t think my symptoms fit with that. Ditto get custom orthoses- I have them. Ditto lose weight- I’m not overweight.

Does anyone have a similar experience or offer me any suggestions? Thank you.

And just to add I have made an appointment with a podiatrist but in the meantime I’m trying to figure out what might be going on. I’m worried they will just suggest insoles.

Sounds like this:

Sesamoiditis: What Is It, Symptoms, Causes & Treatment

Burstitis

Not sure how you spell it, i had an ultrasound I think to look at my foot and thats what they concluded

I get toe pain when my back is playing up - the compressed disc affects my nerves in my toes. It’s much better when I do 10mins of stretches and back exercises before bed.

Alternatively…. gout?

The big toe part sounds exactly what I have, which is hallux limits. It's basically when bone builds up in the joint & causes pain and loss of movement. I also get pain if I've been walking a lot. I've tried orthotics, which didn't really work for me. Sometimes I have no pain at all, other times it's like a rat nawing through my toe. I can really only wear trainers now, no heels. Not even small ones. The only real solution is surgery, unfortunately.

Hallux rigidus.
Metatarsalgia.

Both of these conditions can cause discomfort and pain.

Go to your GP for a referral or several. There is a limit to what shop made orthotics will do. You sound like you need advice from a medically trained specialist.

I have arthritis in my toes joints which is a lot like you’re describing. I can’t bend my toes or flex them (no wearing heels for me!) and they are painful.

It's not plantar fasciitis as that affects the arch it would ping and pull. It doesn't really affect the toes but not sure what else it could be sorry

Complex Regional Pain Syndrome Type II( also known as Sudek's atrophy and reflex sympathetic dystrophy (RSD) - worth having a google. It

https://en.wikipedia.org/wiki/Complex_regional_pain_syndrome

Complex regional pain syndrome (CRPS) is chronic neuropathic pain that follows soft-tissue or bone injury (type I) or nerve injury (type II). It's perfectly possible to have a nerve injury or a soft tissue injury that gives rise to this without knowing about it. It usually starts in/is worse in one limb first.

Arch or the middle of the foot on the underside I meant sorry

It doesn't sound like plantar fasciitis but just for reference, you don't need to be overweight to have this problem. Both DH and DD have had it and myself, I'm the only overweight one. DD was only 15 when she had it, but it was probably a sports injury for her that caused it.

I would take yourself off to the GP, they should be able to help figure out what the problem is or refer you to physio.

Pain as you describe in the joints of my two big toes was the first indication of rheumatoid arthritis but my finger joints also became stiff and swollen. Walking was very painful

It's the combination of big toe and ball of foot pain that makes me thing sesamoiditis.

Sesamoiditis is a specific kind of tendonitis — inflammation of the tendons — that occurs in the ball of the foot. Because the tendons in the ball of the foot have small sesamoid bones embedded in them, these bones can become inflamed along with the tendons. The two pea-sized sesamoid bones sit under the big toe joint, where they provide leverage when the tendons load weight onto the ball of the foot. Activities that frequently transfer weight to the ball of the foot — including running, dancing and walking in high heels — can overstress these tendons and bones, causing inflammation and pain.

Go see a podiatrist, get gait analysis done and casts of feet and then orthotics.
my feet look like I have bunions on the outside of my feet, nope, actually my joints as I have too much bone in each toe. Which has resulted in hammer toes and shortened Achilles. Step extensions help massively as part of the physio relief, the right orthotics (which are recast every 6-12 months) have reduced the width of my feet by 2 inches and to top it off, Morton’s neuroma in both feet which I have had cortisone injections for (MRI scan confirmed). The pain when they flare up is like red hit needles down each toe and like the ball of my foot is on fire. Just other possibilities to explore, I feel your pain.

Long shot but look up Morton's Neuroma (which PP mentioned). I had problems with my feet that I thought were so odd nobody would believe me but it turned out be classic MN in both feet. I have now a bit of arthritis in the joints of the foot to add to the mix. However, having had steroid injections, the right orthotics and shoes now keep it damped down.

I started getting osteoarthritis in my feet in my forties, very painful, I have had flat feet
all my life. Pain in the toes joints can be gout.

I have been out at a concert all evening and just looked now at all of these amazingly helpful suggestions. I am moved almost to tears by the kindness of every one of you for taking the time to post these! I thought I might not get any replies. I will go through every suggestion in detail. Thank you all so much.

Whilst it sounds nuts, it might help working on your pelvic floor. Apparently feet and pelvic floor are strangely connected. Loss of tone in the pelvic floor can cause pain in the feet, whilst it might not be the direct cause it could help, and if it doesn't help the toes it will be good for everything else.

This is exactly how my own RA started too.

I'm 44 and got ongoing issues with one foot, it was so bad this year I could only walk on the side of the foot. The pain was in big toe joint. I had an x-ray which showed arthritis.
I have been wearing a foot splint at night (metal bar down side of foot) to straighten toe and it's made a 90 percent difference as well as exercises from the physio. But as soon as I stop these the issues come back.

i know someone who had pain in their feet for a few years & walking became very difficult. They gave up gluten and within a few weeks all the pain was gone & they were walking normally again. Might be worth a try?

Definitely sounds like hallux limitus which progresses to hallux rigidus. I sympathise, OP, it's really painful.

See a physio,it'll be the best £45 (approx) you spend and they'll have you moving comfortably again in no time.

the pain on your sole sounds like metatarsaglia to me. I had it randomly for 6 months post natally and the consultant said it was due to my hormones and breastfeeding - I thought he was making it up but alas it stopped as soon as I stopped.

things that helped alleviate were in-soles and trainers and exercises. But hormones may be a factor while you are peri.

toes could be osteoarthritis ie wear and tear - insoles to manage it or possible steroid injections. Long term surgery can help