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Q: I recently went on an extended hiking trip. Since then I have been experiencing pain on the top of my foot near my toes. I have noticed a bit of swelling as well. I do not recall injuring my foot but I am concerned that there might be something going o

A: Your symptoms sound like a stress fracture of one of the metatarsal bones behind your toes. Imagine bending a pencil in your hands until it is just about to start cracking and break. That’s sort of what a stress fracture is like in your foot. It’s like the beginning of small, micro-fractures within the bone, occurring from over-use or from low bone density. Early symptoms are pain, redness and swelling. It may be hard to bear weight on your foot. X-rays often show evidence of the fracture within several weeks (maybe not right away). Pain medication can be prescribed if necessary, as well as an icing regimen to reduce inflammation. A special, rocker-bottom fracture boot is usually dispensed, which allows you to walk on your foot and greatly reduces the amount of weight bearing pressure transmitted through your metatarsal bones. Recovery generally takes 6-8 weeks, and surgery is almost never required for this.   

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