It occurs to me that I have two possibly separate problems. The general ache seems to be gradually improving and is probably due to an overly stiff ankle/soleus/achilles tendon. As I am loosening all of that it, the ache seems to be subsiding slowly.
But I also have an intermittent localised sharp pain in the ball of my foot in line with the 3rd/4th toes, which is less predictable. It is sometimes reproducible with anything that resembles a calf raise, including but not limited to calf raises (obv.), walking downstairs, and getting off trains. Diagnostic options for this seem to be:
1. Stress fracture. I always thought that metatarsal stress fractures exhibited problems on the top of the foot, but it often seems to be listed as a cause of metatarsalgia without any further clarification. It’s not impossible that I have some kind of stress reaction/fracture but it’s not really a great fit.
2. Morton’s Neuroma. This is apparently common and the pain is in the right place, but I’ve had unhappy nerves before and there has always been a bit of latency between upsetting them and feeling the results. My pain is instant on applying the right force, and relief is instant on removing it. Also despite the vast number of websites on MN, none (except one forum poster who is kind of a weird case anyway since he’s already had the nerve removed) makes any strong mention of calf raises, and I’m missing all of the other symptoms like numbness and burning and shooting pain sensations, so I don’t think this is it even though statistically it seems like it should be.
3. Gout – don’t think so.
4. Diabetes – don’t think so.
I’ve had an x-ray and blood test now which should provide insight into 1, 3 and 4, but I have to wait a few weeks to find out the results…