medial/top of foot pain

[resptk]

I had bilat plantar faciitis about two years ago. With the use of night splints, stretches, NSAIDs and custom orthotics this problem was taken care of over a year ago.  For several months now I have had progressive pain on my left foot on the medial side just before the arch.  The pain is worse when I walk, but also occurs when i move it just right, put pressure on the ball of my foot, or even if one of the kids puts pressure on my lap when my feet are on the floor.  Walking up or down stairs hurts as well. The pain can either be a dull ache along the side of my foot (not on the bottom) or a shooting pain that goes across the top of my foot (near my leg).  I do seem to have some swelling there as well.  I am overweight.  I work 12 hour shifts at a hopsital...and it is definately worse when the shifts are busy and I am on my feet more.  I used to do the walk fit DVDs, but can't anymore because of the discomfort after only 5 minutes. I can't do any recreational walking anymore because of the pain.  I use New Balance 844 shoes which don't seem to help anymore. The last time I tried to use my orthotics (the ones that were made when I had PF) to see if that would help...it only felt worse.  Any ideas on what this could be?  Should I try a different show?  Should I try the orthotics again?  Maybe I just need to get used to them again?  If I do use the orthotics, do i still need such an expensive shoe?  

I would appreciate any thoughts/ideas on this.  Thank you.

[margypops]

I have for the l;ast couple of weeks had pain across the top of my foor near to where my leg starts I do not remember injuring it at all, seems worse in the morning after rest, I am limping a lot, there is no let up unless I take a pain killer, any more ideas what I can do to relieve this.THANK YOU

[realbullet]

You do need to see a doctor because there are a few things this could be.  Most likely it is posterior tibialis (most common in women over 40 & is compounded by being overweight).  The pain on the top of the foot is most likely either arthritis (common problem associated with posterior tibial tendon dysfunction) or a strain in the anterior tibial tendon.  It could also be a ligament tear or even a broken bone.

You will probably need a different type of orthotic with either a higher arch or a support up the medial side of the foot -- sometimes the doctor will suggest a brace such as an Arizona brace (if you have the choice try the orthotic first)

Yes, you will need to keep buying better shoes.  It does no good to put an orthotic in a cheap shoe.  I've had better success with the Brooks Ariel or Addiction Walker than the New Balance 844.

[resptk]

Thank you...I will make an appointment.  I really  appreciate your guaidance in this matter.

[Yena H Do, DPM]

get an mri to see if your ruptured your spring ligament and to evaluate your posterior tibialis muscle.  you may have strained either one of them, which would explain the swelling and continued pain w/o relief from orthtotics.