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1536 Views 5 Replies Latest reply: Oct 29, 2011 10:34 AM by firstcampgirl
GeeRaCeR Rookie 5 posts since
Sep 30, 2011
Currently Being Moderated

Sep 30, 2011 1:20 AM

Neuroma/Metarsalgia Treatment/diagnosis please help

For the past 3 months or so I have been getting numbness/pain in my right foot. It began with numbness on the top of the foot round the 3rd/4th metatarsals and then progressed to pain, this then improved but my 5th metatarsal tendon then became inflammed and painful, now this has subsided but the numbness has come back and is now under the foot/toes as well! I am wondering what this is and how to fix it! There is no swelling but my 3rd and 4th metatarsals heads may have dropped slightly also bm 2nd toe is longer than the 1st so thought it might be Morton's neuroma. I am a keen runner/triathlete and have reluctantly backed off training but it hasn't really helped, have been seeing a physio too. Has anyone else had a similar experience and if so how did you treat it?

Thanks

  • JamesJohnsonLMT Legend 1,162 posts since
    Aug 23, 2009
    Currently Being Moderated
    1. Sep 30, 2011 10:19 AM (in response to GeeRaCeR)
    Re: Neuroma/Metarsalgia Treatment/diagnosis please help

    The length of the second toe is not as important as the length of the second metatarsal when it comes to diagnosing Morton's TOE (or Morton's FOOT, Named after Dr. Dudley Morton), which is different from a Morton's NEUROMA, named after a different Dr. Morton (Thomas, unrelated, though Durlacher described it first.) The two conditions can often be found together, but are not necessarily directly related.

     

    It is presumed that a short 1st metatarsal (vs. the 2nd, in a Morton's Foot) causes a roll of the foot toward the short 1st into overpronation (for support), forcing a cascade of the remaining metatarsals in a rubbing action that can irritate the nerves between them, leading to eventual entrapment and compression. Regardless of the cause, what we call a Morton's Neuroma is not really a true neuroma, but a perineural fibrosis. Read about it, including differential diagnoses, in the link below. Some of what you describe is discussed here:

     

    http://www.wheelessonline.com/ortho/mortons_neuroma_interdigital_perineural_fibrosis

     

    Some MN sufferers find relief by placing a small pad underneath the ball of the foot (1st metatarsal head), in order to simulate a longer metatarsal, which tends to minimize the excess motion by retraining the brain's perception of metatarsal length. Others may find this irritating. There is usually a sesamoid bone and an ample fat pad at this spot, but not in all cases, and there is the danger of exacerbating the problem into chondromalacia, sesamoiditis or atrophy of the fat pad. Read more here:

     

    http://www.myfootshop.com/detail.asp?condition=sesamoiditis

     

    Woe to those who suffer from those conditions and MN, because there is no place to go when retraining the footstrike to avoid irritation. As noted in the link above, an ample toe box and minimal heel elevation at all times (not just in running shoes) can help to alleviate symptoms.

     

    If indeed you have the dreaded Morton's Foot, your symptoms would probably go beyond foot pain into leg, hip, and back pain, perhaps even including chronic headaches. The adaptations it causes can be that far-reaching. Since you indicate that you have been a keen runner trathlete, perhaps metatarsalgia or some of the other maladies mentioned, including lumbar problems, are the culprit. If you find you are without these other symptoms, but the foot structure is suspect, I offer this informative link to Dr. Brent Jarrett's site where he sells orthotics targeted at this particular foot problem. He has commented on these posts before and has a better grip on the problem than most foot doctors ever will. Here is his site with further info:

     

    http://www.pcopco.com/neuromas.html?gclid=CKa1xLSnxasCFcTD7QodxR-09Q

  • susie815 Rookie 2 posts since
    Jul 7, 2011
    Currently Being Moderated
    2. Oct 1, 2011 1:58 PM (in response to GeeRaCeR)
    Neuroma/Metarsalgia Treatment/diagnosis please help

    Hi, Does sound like a mortons neuroma, I had for a year, i tryed everything, orthotics, wide toe shoes, physical therapy, massage therapy, accupunture, i even went to a chiropractor, I eventually had surgery july 1, 2011, i posted right after my surgery and no i am updating,  It has been 3 months and i totally regret having this surgery. Once i went back to work, i had swelling and pain like crazy. My foot would even turn purple only after 2 hrs of being up. I went to a different doctor, orthopedic surg and he diagnosised me with complex pain sydrome. So kind got suck it up and more time. Well today i went to yet another doc, i cant go 2 hours on my feet and the pain is so bad and the swelling...so this podiatrist told me that i have a stump neuroma which is a side effect of this surgery for some people. So now i am back to square one and in more pain than ever..i have missed so much work.. Now this doctor is saying alcohol injections to burn those nerves, which is what i wanted to do from the begining but the first Dr. didnt do those. So i opted for the surgery. so now i am getting ready to see if these will help..PLEASE PLEASE DO NOT LET ANYONE TALK YOU INTO SURGERY for this..i would try anyting than surgery. try the alcohol injections before you go for the surgery...please...

  • firstcampgirl Pro 73 posts since
    Sep 28, 2010
    Currently Being Moderated
    3. Oct 13, 2011 7:58 AM (in response to GeeRaCeR)
    Neuroma/Metarsalgia Treatment/diagnosis please help

    I have a similar problem. I am a new runner, only running for a year now. Pain started in May when I increased the mileage a bit too much in a short time.  The pain got worse over the summer and I had to cut back on running and was limping at times just to walk around. I finally went to a podiatrist (i have terrible insurance so it is expensive). He says I have a hammer toe and it is causing the pain, he can feel the inflammed area in between the metatarsals.  He wanted to give me a cortisone shot but I declined.  I was given a rx for an anti inflammatory and it worked wonders. I took it morning and night for 20 days and was nearly pain free. Etocolac is the medication.  He also recommended that I soak my foot. Alternating between cold and warm water, 30 secs each for about 5 minutes daily. I do that and I ice after a run.

     

    Once I finished with the medication, the pain returned. But the soaking seems to help. I don't want to take medication all of the time, so I got a refill and I take it for 2 days prior to a long run through 2 days after. That seems to help.

     

    I also switched to a shoe with a firmer sole at the recommendation of my local run store folks.  So, I have less pain but it's still bothersome and I am now training for my first marathon and I am concerned about how it will go and how often it is wise to take this medication.

     

    Podiatrist suggests custom orthotics for $400 but I haven't found anyone with this diagnosis who says that they helped so I don't want to waste that kind of money.

     

    I tried metatarsal pads and they seemed to increase my pain and they were very annoying during a run.

     

    Susie- so sorry for your troubles and thanks for sharing your story.





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  • firstcampgirl Pro 73 posts since
    Sep 28, 2010
    Currently Being Moderated
    4. Oct 13, 2011 8:05 AM (in response to GeeRaCeR)
    Neuroma/Metarsalgia Treatment/diagnosis please help

    http://www.bauerfeind-store.com/bauerfeind_viscopeds.html

     

     

    I wonder if anyone has tried the inserts listed above. I am considering them as a much cheaper option when compared to custom insoles. These also come with and without metatarsal pads which are painful and annoying to me but are recommended to some with the same pain that I have.





    Newbie (wannabe) Runner

    5k- Nov 20, 2010 38 mins

    5k- Dec 7, 2010 36 mins

    Snapple High Could Half Marathon 3:15

    Half Marathon, Shamrock- March 20, 2011

    Cherry Blossom 10 miler April 3, 2011

    Warrior Dash May 21, 2011

  • firstcampgirl Pro 73 posts since
    Sep 28, 2010
    Currently Being Moderated
    5. Oct 29, 2011 10:34 AM (in response to GeeRaCeR)
    Neuroma/Metarsalgia Treatment/diagnosis please help

    Just updating...I have gotten alot of relief by avoiding being barefoot on our hardwood and tile floors. I wear crocs around the house most of the time.

     

    I have also beeing doing A LOT of icing. I soak my foot in ice water, daily.  I am not taking the RX anymore and my pain in tolerable and I am still running. Good Luck to others!

     

    I also started wearing Health Toes toe stretchers for about 10 mins daily, usually while I watch tv. I don't see a dramatic improvement but it's not gotten worse. ($14 on Amazon)





    Newbie (wannabe) Runner

    5k- Nov 20, 2010 38 mins

    5k- Dec 7, 2010 36 mins

    Snapple High Could Half Marathon 3:15

    Half Marathon, Shamrock- March 20, 2011

    Cherry Blossom 10 miler April 3, 2011

    Warrior Dash May 21, 2011

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