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I am new to this forum, have been a competative runner for about 8 yrs now, and have in the past two years,developed some intense pain in my left foot. This was diagnosed as Morton's neuroma between my 2nd and 3rd metatarsals. I had surgery....after the NSIAD/Cortisone treatments, to excise this. Strange thing was, my last visit prior to the surgery, I had informed my Ortho that I felt similar pain between 3rd and 4th meta's, in the same location of my foot - ball joint area. I have healed from last years surgery, and been able to do minimal running and bike riding, but not ever be really able to "hammer down" due to continued "feels like a stone in the base of my 3rd meta joint" pain. I have tentatively scheduled to have a second MN removed from the opposite side of my 3rd digit......but there is this question still floating around my head, about whether it is Metatarsalgia(SP?).
Is there any way to determine MN from Metatarsalgia? I really hate to face the fact that I could potentially end up losing my toe, due to last nerve being attached to artery, and potentially losing blood supply to that toe. On the flip side, i don't want to give up an active lifestyle either, and be stuck with just a painful walk.
All thoughts and suggestions and professional advice appreciated.
In your discussion about prior treatment you did not mention shoe and shoe insert therapy (orthotics and pads). If you have not tried reversible therapy of shoe therapy and shoe insert therapy you should do so before you let some one do non-reversible therapy (surgery). In my experience pain in the forefoot, either neuroma pain or metatarsalgia pain is related to wearing in correct shoe size. Shoes that are too small or shoes that are too loose can stress the forefoot. If there was stress between the metatarsal bones which irritate the nerve, cutting the nerve out does not address the reason why there is excess stress between the metatarsal bones. Look for someone who has knowledge about foot issues and shoe wear, go to Find a PT. Take a look at Who you going to call - Choosing a Healthcare Professional. My friend the surgeon says "going to a surgeon is like a chicken going to see Colonel Sanders.
Damien Howell PT, DPT, OCS - www.damienhowellpt.com
First, thank you for taking the time to give your professional thoughts on my problem. I did in fact go to an Orthopedic Physician, prior to the Surgeon and a PT before that (another issue, knee related), but she looked my foot over too, as this occured during the time I was getting the therapy for my knee. I was fitted twice for orthopedic inserts, which aggravated the area even more. I followed the "break them in slowly" method of wearing them for short periods of time, then gradually working in them all day. This was not an inexpensive set of inserts either, which is why the second ones they made were 'on the house". I really wanted to approach this from a non-surgical standpoint. Shoes I had fitted were a half size larger, just to make sure the toe box gave me enough room for my forefoot to swell, and not irritate. All to no avail. It was then that I went out of State, to Ortho Surgeon in Ohio, outside Columbus, who specializes in running and sports related foot/ankle injuries. Did the steroid injection at that point - he would only do the one, due to concerns of damage to fatty tissue that would not grow back. The injection gave me a whole five days of pain free walking/running......then the pain came back. Both of these guys tell me that there is not a good way to determine between Metatarsalgia and MN. I had the MRI and X-Rays done, and still nothing conclusive. Surgeon "pinched" up between the web spaces on either side of my third digit, and said most likely a double Neuroma. The mass feels like it is directly at the joint of this third digit - at the ball of my foot. When trying to balance on this foot(left), It feels like there is a knot right in middle of the ball of my foot, which causes me to "tip" to one side of the other. very bothersome, and I cannot get a good push-off when I run, or pedaling on my bikes. I am more than willing to get another opinion on this, but do not have any idea who to see next. Surgery is slated for December, so I have some time.
Boils down to this for me. I am 48.5 years young. I have been very physically active my whole life, started swimming competitively at 6, and the only way to get from point A to point B for me for 15 years was to walk,run or bike. I don't want to lose this ability, but I also need to be able to stand and walk with pain no worse that it currently is. I cannot jeopardize my ability to perform my job. The other issue is insurance. I currently have good insurance, but in these challenging times, one cannot guarantee what I may have several years down the road, so the sooner I can get this taken care of, the better my chances are to get back to my normal level of activities and minimize my expenses.
I live in central WV, between Parkersburg and Charleston. I would like to find someone within a 3 hr drive, to give me another opinion, prior to having the surgery. You don't happen to have a crystal ball, that you can look into, for some contact info for me do you?
Thanks again - I appreciate your time.