Neuroma

GOLFNSKI · Nov 25, 2007

I've been running on and off for 25 years. Never a foot problem. Three months ago I laced up my trail shoes for a 10 miler and after about 1/4 mile I felt like my sock was bunched up. Took my shoe off, to find it wasn't; repeated this again; then said screw it and just ran on it. Since then the sensation has come and gone. The last month it bothered me regularly, and sometimes would hurt when I walk. It feels like a ligament clicking in my third toe. Sometimes it feels like my fourth toe. I thought I was nuts not being able to tell which toe was injured. When I run, it bothers me for about a mile so I curl my toes to alleviate aggravating it for a while and it gets a little numb after a while. Now it bothers me most of the time, so I went to a Podiatrist to see what’s going on. So it turns out it’s not my toes, Pod says it’s a nerve in the ball of my foot. A neuroma or possibly neuritis. I had never heard of this before so I’ve done some research on it. The Pod said I'm only a moderate pronator and said orthotics might help but didn't stress them for me. He felt motion control shoes are adequate. I decided to order the orthotics anyway. I figure it might help and it probably won’t hurt. He had the nurse tape me (first a horse shoe shape around the outside of my foot from knuckle to heel to knuckle, then two loops kind of loose around my foot top to bottom). This was done to keep my foot from spreading out too far. He said no restrictions on running walking or whatever and come back in a week. He said the next progression would be cortisone injections, then possibly alcohol injections and then surgery, but that he felt we caught mine early and it might go away before the invasive stuff. I'm trying to figure out why this would suddenly affect me. No recent shoe changes. We did move into a house in April 2007 with hard wood floors and slate floors and I’ve gone barefoot a lot this summer. I wonder if this caused it. Maybe walking on the hard floors made my foot spread out like a pancake and pinch the nerve when I had my trail shoes on (they are a little, but not overly snug). It would have been 4 months after moving that I first felt the sensation. What’s remarkable to me, is the Pod doesn’t seem interested in what caused the neuroma. I’ve read that some people get it from being over pronators with musculoskeletal problems. Some people get it from wearing shoes that are too tight. I would think the approach to dealing with it would be different in these two cases. I’m convinced that mine is caused by either the sudden abundance of barefoot walking on hard floors this summer, and/or my trail shoes were too tight on a couple runs. I’ve read that most people with a neuroma seem to be comfortable barefoot, but when they get shoes on they hurt. I’m the opposite. If I go barefoot, I have to limp in order to prevent the pain. I feel better in shoes. I have to wear shoes at all time now. Common sense tells me I should get on crutches for a week or three and this should go away, but the pod says not necessary; live life normal. That’s hard to comprehend, but since I don't want to quit running, I'm following Dr’s orders. I went back to the POD last Tuesday and he gave me a cortisone injection. It made me numb for a day, then sore for a couple days, now it’s the way it was before the injection. CRAP! From my research, it seems no two Pods have the same opinion on the best method to tackle this. Some are against surgery. Some are against alcohol shots. Some do Cryo Surgery. Some recommend an MRI. Some say an MRI is a waste of time. I’m considering going right to surgery. Alcohol shots only cure 70% +/- of mild cases and the alcohol just kills the nerve anyway, so why not just cut it out? I don’t have insurance and don’t want to spend al the $$$ on stuff that isn’t going to just fix the problem. This sure is frustrating. Anybody else have experience with this?

merigayle · Nov 25, 2007

hmmmm. i remember reading on the ultra list that a runner had a neuroma and he cut a hole in his insole to relieve the pressure on that part of his foot and that helped him tremendously.

fox-runr · Nov 25, 2007

I had morton's toe pretty bad years ago and kept running until the pain was shooting up my leg. The podiatrist made an orthotic, which I hated. adding pads and stuff just make shoes tighter. Thinking back, I think Meri's friend has it right, take something out of the shoe. In the end, I had to stop running for awhile, and when I returned I threw away most of my work shoes (high heels), when I was at my desk, I wore slip on loafers and only slipped into my heels, if I had to see some higher ups. and moved 1/2 size up in running shoes. 
You may be right about the change in flooring. My plantar fascitis came right after a move to a house that was almost exclusively wood and tile, and I'm not a slipper or socks person.

Nettie · Nov 25, 2007

I think my friend has the same issue and the cortisone and alcohol shots just made things worse. She still doesn't know what to do, but is about to see another podiatrist that is highly recommended, so I'll let you know what happens.

GOLFNSKI · Nov 26, 2007

Hi Merygayle, I remember you from an Ultra / Trail Running forum I used to visit. Thanks for your response. I’ve seen a picture of a modified insole made by a person with a neuroma and I might try it if I can’t get rid of the problem altogether. Thanks Fox. My second toe happens to be longer than my first toe too, but it’s never caused me pain. (Mortins Toe is a totally diffent ailment than Mortons Neuroma). I hope your solution has you pain free. Nettie, I’m really looking forward to your friend’s second opinion. I’ve got orthotics on order, but no other treatment planned yet. I don’t think this is going to go away by itself either. As it’s not debilitating yet, I’ll keep researching and learning. I'm the only case I've seen that is more comfortable in shoes than barefoot or socks. Hmmm.

toe jam on crusty feet · Nov 26, 2007

First off, I would STRONGLY encourage you- as I do everyone- to not let the doc do any other shots unless you are in excruciating pain and even discontinuing exercise does not get you pain free. Cortisone shots have their place but they get used way too often and in the end can cause more damage than good. 
Neuromas are a tricky thing and there are a lot of opinions out there. Even trigger point therapists have an opinion on this (and it does not always appear to have muscular beginnings). I will look at my text book and see what it says about neuroma, from a trigger point therapist standpoint. (I have not had to deal with it in a client). I would definitely start to wear shoes inside and something with a sole that is somewhat supportive. I have all tile and I wear flip-flops inside that have a sole like a running shoe. I think the big thing is to alleviate the pressure ( modified insole maybe?) to allow the area to relax and be pain free for a while. I struggled with a neuroma in the ball of my foot, but after a short running hiatus from another injury, mine just went away. 
I hope you are able to find a solution and I am glad to see you question the fact that the POD doesn't seem to care about what is causing the problem! Good on ya!

hup · Nov 26, 2007

Hello & welcome. Sorry to read of your foot troubles. I've dealt with neuroma pain for going on 4 years, for a time severe enough to stop my running for more than a month. 
I at first ignored it, figuring it would just go away. Not too smart. I finally visited a podiatrist and he took me through a modified off the shelf insole, then a cortisone shot, then a custom orthotic that included a metatarsal pad and had an indentation under the site of the neuroma to relieve pressure. The insole and shot did nothing, the orthotic did help. I got the most relief from going to a 1/2 size larger shoe (a new model that was wider in the toebox) I always thought I had narrow feet, but the relief that I got with a wider shoe convinced me that either I was mistaken or my narrow foot had spread with 15+ years of running. I also did (do) a great deal of self massage on my foot, including gently pulling my toes apart to regain some of that long lost elasticity in my feet. 
At work I wear a Lynco insole with met pad in a shoe that doesn't squeeze my forefoot at all. 
Good luck with this, feel free to ask if you have any questions about my experience with this condition. 
hup 
p.s. I don't quite understand your pod taping your foot to keep from spreading. I found that allowing my foot to spread out more or less naturally gave me far more relief than compressing it in some way. YMMV.

Neuroma

GOLFNSKI

merigayle

fox-runr

Nettie

GOLFNSKI

toe jam on crusty feet

hup

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