Q: I’m a 55-year-old man in good health but these last two years I have
been experiencing pain in the soles of my feet. I find it hard to walk
when I have to get up in the night. I’m taking high potency
multivitamins. It seems to be worse when I don’t take them. What
deficiency do I have?
A:Although this sounds like a simple question, there is no quick and
easy answer. Pain in the sole of the foot can be caused by a number of
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different things, ranging from a plantar wart to rare genetic disorders
like Marfan’s syndrome.
A lot of people incorrectly name plantar warts planter’s warts. It has
nothing to do with planting a garden; plantar refers simply to the
sole of the foot. If it is a wart, a visit to the podiatrist should
fix the problem. He may have to freeze or burn it away.
Morton’s neuroma is a common foot malady caused by enlargement and
inflammation of a nerve, usually at the ball of the foot at the base of
the third and fourth toes.
Symptoms include sharp pain, burning, tingling or numbness to the
affected area. Surrounding muscles may cramp. These problems get worse
when you have been standing or walking more than usual. In women, shoes
with pointed toes and high heels used to be a major cause, but as this
type of footwear is not so fashionable, we see fewer cases.
Treatment consists of an orthotic device known as a metatarsal bar or
pad, which is placed inside the shoe just behind the ball of the foot.
This takes the pressure off the affected nerve by lifting up the front
transverse arch.
Sometimes, pain in the soles of the feet can arise from compression of
a nerve root in the lumbar spine, or even arthritis of the hip joint.
Do you have any arthritis, or have you ever had a back injury? You may
need to see a neurologist for an EMG or an MRI in addition to a back or
hip X-ray.
I doubt if you still have any vitamin or mineral deficiency if you have
been taking high potency multivitamins. Extra B vitamins would be
beneficial if you have diabetic or alcoholic neuropathy. These
peripheral nerve diseases affect the extremities, and lead to weakness
and muscle wasting.
Vitamin B12 deficiency can occasionally cause foot pain, but there are
also other symptoms such as anemia and depression. Taking this vitamin
by mouth doesn’t help, as it is not absorbed well through the stomach.
It needs to be injected by your doctor.
Clare Rowson is a medical doctor with a practice near Belleville, Ont.
Her columns are intended for general information only. Individuals are
encouraged to also seek the advice of their own doctor regarding
medical questions and treatments.
