Foot pain/Morton's Neuroma

scbj1909

Barefooters
Apr 8, 2014
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My problem is changing my life in ways I do not like and want to reverse. My right foot has been hurting for about 6 months. It started when I was playing tennis. Around the end of the 2nd set it would be very painful, it felt like walking on hot coals, that progressed to it hurting in warm-up to the point that I quit playing tennis 2 months ago. I could not walk or run more than a block or 2 before the pain became unbearable. The pain centered around my big toe and the ball of my foot. My big toe and most of my toes were numb. I was having a hard time sleeping through the night due to the pain.

I have a lump just forward of the ball of my foot, at the base of the 2nd toe. (The doctor said it was a neuroma). The lump does not hurt if touched but hurts if pressed. The podiatrist gave me a cortisone shot between the 2nd and 3rd toes. That did not do anything that I could tell. A month later he gave me another between the big toe and the 2nd toe. That helped a lot. The numbness is much reduced and I can now walk quite a ways with some discomfort at the end but bearable. However, it still hurts too much to continue playing tennis for more than 10-15 minutes or running any distance.

I was very hopeful that further treatments would allow me to return to my normal life but at my last appointment the doctor did nothing but recommend insoles and cushions. He said he could not give me any more cortisone shots now and did not recommend surgery.

I have tried every cushion I could find, superfeet, spenco, Dr Shols and various off the rack pads. These help a bit but don't work for tennis or running. I am considering surgery if it would help but I want to explore all my options. I am considering seeking a 2nd opinion. Would this be a waste of money or is there something that could help me?


I may not have a Morton's neuroma since my lump is behind the 2nd toe. Does this make any difference as far as the treatment? If mine is not a Morton's neuroma, what is it?
 
Hello scbj -

Thank you for your message and I understand your frustrations from the foot pain.

Based on how you describe your symptoms I'm not fully convinced that what you are describing is neuroma pain. You are describing a pain that is in all of your digits? Although you can have more than one neuroma in your foot, to have all digits go numb from neuroma pain is rare. It is possible that you have more plantar adhesions or myofascial stickiness that is putting pressure on your plantar nerves causing the numbness.

As far as the lump on the 2nd digit I've never seen a neuroma that you can actually palpate and visualize above the skin. Neuroma's are deeper in the interspace and are classically sitting just proximal to the metatarsal head.

If you have not had an MRI of your foot I would recommend having this done to confirm that there are in fact neuromas - and between which digits.

If you do in fact have a neuroma(s) then I have great success with sclerosing agent injections. I typically do not do the steroid injections in confirmed neuromas as they do not last that long and do not address why the neuroma pain is occurring. I typically do not find much success with inserts and therefore recommend the sclerosing agent injections following by radio frequency ablation.

I hope this helps!
 
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Sounds like a mortons neuroma but that is likely too simplistic. One question I would have is does your second toe look shorter than the first or longer. That can make a difference on how you toe off when you walk. My guess is that you have a muscular entrapment in your calf, which will stiffen the toes and cause you to hit the ground hard with your forefoot. That can inflame the sessamoid bones (small bones in that area you described) which can be quite painful. Perhaps, this is why the second injection offered some relief however, I do not think that solved your problem, but it may have relieved it.

The other thing that comes to mind is what your overall gait is, since problems in the calf often affect other areas such as the gluts, and your lower back. A good sports chiropractor who specialises in myofascial release or ART or Graston technique may be the right person to help you sort this out.

I hope that helps
 
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Hi,
There are a number of good options for the non surgical treatment of Morton's neuroma. Our website has a lot of useful information on non surgical options for Morton's neuroma.
Good luck.
 

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