
My foot after re injury
Hi everyone,
I’ve been dealing with a complicated right forefoot issue for months and I’m trying to understand whether this sounds more like persistent bone stress / post-traumatic neurovascular sensitization or something closer to CRPS.
I still have pain in my big toe tendon when flexing to myself and a small bone edema on my MTP1 because of my injury
Timeline:
INITIAL INJURY:
07/2025:
- Fracture of the 3rd metatarsal + avulsion injury near toe
- Treated with Aircast for ~2 months
- Recovery went very well afterward:
- pain-free walking
- able to jog
- no major redness or burning
- almost functionally normal
SECOND TRAUMA:
05 Oct 2025:
- Twisting/overstretching trauma to the right forefoot while lifting/throwing someone sideways
- Only rested for ~3 days afterward
- Then progressively increased activity myself:
- gym
- 4-6k steps/day
- stairs
- calf raises
- leg extensions
- squats etc.
In retrospect I think the area was not fully healed and I overloaded it too early.
IMPORTANT DETAIL – NOVEMBER 2025:
At the end of November I had final exams.
During that time I was able to:
- stand for ~20 minutes and longer without problems
- walk (with slight limping because of occasional toe tendon discomfort)
- sit for long periods both feet’s down 2 hour exam
- drive for ~30 min back home and to get there 30 min
At that stage:
- NO burning
- NO major redness
- only occasional “twinges” near the toe because of tendo
Then in early December I started:
- calf raises standing
- squats bodyweight
- leg extensions
- lots of walking/stairs
- toe exercises with towel grabbing from bottom up (this + calf raises did the worst)
This significantly worsened everything I got redness, swelling, warm and some burning
I repeatedly paused for short period 3 weeks and could walk normally again. After this I took orthopedics soles which I was thought gonna help me recover but it always triggered my foot at walking standing. I was able to lift 44-46kg dumbells with a aircast on at February without redness burning. But with these soles my foot got red and burning
IMAGING / DIAGNOSTICS:
MRI (01/2026):
- mild bone marrow edema at:
- base of MT-1
- medial cuneiform
- MTP-1 region
X-ray: march
- demineralization / “milky bone”
Also:
- cartilage damage at MTP-1
CURRENT SYMPTOMS:
Main symptoms are LOAD DEPENDENT not at chilling on computer or lying down.
- burning in forefoot
- redness
- warmth
At rest:
- mornings are usually almost completely normal
- normal color
- often no burning at all
Symptoms are triggered by:
- standing
- walking
- driving (pressure on forefoot/pedals)
- axial loading
- leg exercises
Symptoms improve quickly with:
- elevation 5-10 sec color back to normal
- unloading
- cold
- taping I recognize by taping the big toe joint the burning is not that much like without and the redness is only on toe 2-3 see picture
- carbon sole
- scholl soles
Redness usually normalizes within seconds/minutes after elevating the foot.
CURRENT FUNCTION:
- able to walk
- strength preserved
- mobility mostly preserved
- slight restriction in big toe
- foot is strong power is there
I also have reproducible pulling/tightness when actively dorsiflexing the big toe, possibly involving:
- extensor tendon irritation
- capsule irritation around MTP-1
IMPORTANT:
- no paralysis
- no major stiffness
- no allodynia
- no pain sleeping
MEDICATION RESPONSE:
NSAR
- had ~41 hours with almost complete symptom relief
- basically no burning, felt normal BUT I did again some leg work which f me up again
Corticosteroids:
- strong temporary improvement
Gabapentin:
- no major benefit so far
Amitriptyline:
- helps sleep
—> the change from ortopadics soles to Scholls had a better impact than all the meds!! I was after half n hour more able to walk and stand without burning redness like before
MECHANICAL SUPPORT:
Big recent development:
I changed orthotics recently (~1 week ago) and noticed a VERY significant improvement in:
- burning
- standing tolerance
- walking tolerance
This made me wonder whether my previous orthotics may have been mechanically irritating the area and preventing healing.
Carbon sole + taping also clearly reduce symptoms.
MY CURRENT THEORY:
This feels more like:
- persistent/reactivated bone stress injury / marrow edema
- mechanical overload of MTP-1 / MT-1 region
- secondary neurovascular sensitization
rather than classic severe CRPS.
Reasons:
- symptoms are highly mechanical/load dependent
- mornings are often normal
- symptoms improve rapidly with elevation
- no severe allodynia
- no major movement loss
- clear response to mechanical offloading
I’m 27 years old and overall the foot actually looks and feels better than it did in Dec/Jan:
- less diffuse redness
- less burning
- symptoms more controllable
But I still get flare-ups if I overload it.
Example:
Recently I felt much better on Celecoxib and then did:
- 10 min cardio bike
- leg extensions
After that the burning and redness returned again (though less severe than before).
Questions:
- Does this sound more like persistent bone stress reaction + neurovascular sensitization than true CRPS?
- Can bone marrow edema stay mechanically reactive this long?
- how can I get the blood flow back to normal ?
- Has anyone experienced redness/burning that was strongly dependent on orthotics/shoe mechanics?
- Is full recovery realistic in cases like this?
Would appreciate any thoughts or similar experiences.