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Hi everyone,
I had a lady see me yesterday about a burning left 5th toe. She finds it very uncomfotable and says it occurs sometimes at night and sometimes when driving.
There was no sign of tinea, no corn/callous, footwear is good, no Diabetes, she is in good health.
Foot function is rel normal.
The only thing i could find was a slightly more pronated stance and gait pattern and some mild callous formation along the border between 1st and 2nd mtpj on left foot only.
This pronation was only very slight and still within normal limits for a gait pattern.
She says he burning feel like it is in the skin only and not deeper.
I have suggested she try an anti-inflam gel when it burns to see if that helps, slight possiblilty that it could be arthritis (the dipj's of most toes are unable to be straightened completely).
I would appreciate any suggestions. It has stumped me,
There are no other symptoms, it is only the left 5th toe.
Burning symptoms typically = nerve pain (ie impingement etc).
Check the digital nerves and sural nerve by percussion (ie Tinel's sign). It is likely there is an entrapment somewhere locally, or there could be some referred pain from more proximal.
It is not unusual at all to see entrapment of the sural N. and branches causing discomfort in the 5th toe. Steroid injection or surgical release is usually warranted if there is a positive Tinel's sign somewhere along the course of the nerve.
Get an x-ray also to check the osseous morphology of the phalanges of the 5th toe - which could be causing local irritation on the nerve. Arthroplasty can be an option here.
LL
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***************************************** Remember, it's just a foot.
Hi, my 70 plus year old mum had this problem!!
I was unable to diagnose aetiology??
Ma tried a silipos toe cover worn at night.
Cured!!
NO symptoms!!
Perhaps worth a try??
cheers
h
Hi Simone:
Re: 5th digit burning.
If you can't find an obvious etiology, you might suspect an atypical tarsal tunnel syndrome or lateral plantar nerve compression.
I've had a few of these - easier to Dx after the patient has "been around" and hasn't been helped by treatments aimed at the usual underlying etiologies. One other thought is an old cold injury / pernio for instance.
Steve
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DrSArbes
Fellow American College of Foot & Ankle Surgeons
Board Certified Foot & Ankle Surgery, ABPS
Green Bay, Wisconsin, USA
I always try to think in the simplest explanation before passing to a more complex one. Did she not wear a different kind of shoe recently? Any kind of unusual event as a long walk/standing with dressing shoes?
I had a similar case once. I suspected of periosteum rupture. The local anti-inflammatory treatment worked well…
Are there any signs of inflammation?
I also agree with Lucky “Get an x-ray also to check the osseous morphology of the phalanges of the 5th toe”.
Hey got to agree with nerve compression. had good response from manipulation along pathway. Well worth a try before cortisone or surgery. If you haven't had any experience some physio's , exercise physiologists, remedial massage people can do it. Robyn Gant in Sydney ran some courses at the NSW pod rooms for soft tissue mobilisation. So far cross our toes had great results for stubborn problems like these that no one else knows what to do with.
Hello,I havent been on here for awhile and realised I never got back to you all. I just tried some mobilisation and that seemed to work well. She hasn't had any symptoms (as far as I know) since.
Very interesting repsonses though and I will keep them in mind if I ever come across this problem again.
Cheers
Burning 5th toe
Re: Burning 5th toe
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