For a number of years now (more than five), I have had severe pain in my fourth toe on my left foot (the toe next to the pinky toe) whenever I am standing for any length of time in closed-toe shoes, or when I walk in running shoes or go for a hike. (Forget high heels -- just thinking about it makes my toe hurt). Luckily for me, I live in California and so can wear birkenstocks for much of the year and clogs the rest of the time. So generally, it doesn't bother me. But I do like to hike and walk, and that is becoming increasingly difficult to do at any length. I wear wide shoes tied very loosely, and even so, have to stop periodically, take my shoe off and flex my toes. That helps for a little while, and then I have to do it again. Just to be clear, it's only the toe that hurts, not the ball of the foot or the third toe. And the pain is quite severe -- like having your toe stepped on by a heavy person with a stiff shoe.
My PCP referred me to a podiatrist, who I saw today. She thought my symptoms sounded similar to Morton's neuroma, though not the "classic" symptoms (this much I'd figured out on my own). She felt my foot and pressed in the usual area for Morton's neuroma. My toe hurt a little bit when she did that, but nowhere near as much it hurts when I hike. Morton's neuroma seemed to be the only thing she could think it might be, so she gave me an injection (cortisone, I guess) and had me make an appointment for orthotics.
Of course, I can -- and will -- just wait and see if this course of treatment helps me. But I am left feeling that I might not have gotten the right diagnosis, and am wondering what else it could be, and how one could tell if it was something else that was causing my toe pain.
I've had MN and it is definitely in the pad of the foot - not the toe. And cortizone injections won't help MN - alcohol injections are the only ones that even have a chance of working and they don't always (3 injections maximum). I strongly suggest you see a sports med ortho who specializes in feet. If you live in a city with a pro football or basketball team or near a major university with an athletic department, find out who they use and go see that person.
I am currently receiving treatment for a neuroma. Mine is between the second and third toes left of the big toe. My symptoms were sharp pains and burning in my foot. The pain didn't seem to be in the foot pad but in the toes. Once I took my shoe off, the symptoms would disappear. I tried to recreate the pain by pressing on all parts of my foot, but I couldn't force the pain. It started by feeling like my toes were pushing into my shoe. I thought maybe my socks were too tight.
Several years ago I went to buys sneakers and the clerk said that I should get orthotics because I have really high arches and a bunion on one foot. I went to a podiatrist and got orthotics. They were off the shelf and not custom. I wear these in my golf shoes, sneakers, and clogs (Merrill's). I didn't have any problems until last September. I was on vacation for 3 weeks and walked constantly wearing either my clogs or sneakers, always with my inserts. During the 3rd week I started getting pains in my foot like my toes were hitting the end of the shoes. I thought my socks were too tight. I ended up buying some gel toe separators and that helped.
I went to see my podiatrist when I returned and he took one look at my feet and said that I had a neuroma. He could tell because my toes were separated. He could also feel it when he pressed between my toes. He gave me a cortisone shot and said that it may help. It didn't.
I am now in the process of getting alcohol injections. He suggests surgery as a last resort. I have had 7 injections, each 2 weeks apart. I have only had the pain a couple of times since I started. I only wear sandals (Chaco) or my golf shoes. It feels funny when I go barefoot. I am going for 1 more appointment. Not sure whether we will do another shot or not. The good news is that I've been able to golf all summer and usually walk the course. The only other discomfort that I have is that two of my toes push into each other.
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bb77bb, your symptoms sound very similar to mine -- the same type of pain, under similar circumstances, but not being able to recreate the pain by pressing on the foot -- although my toes aren't particularly separated. Did you ever try custom orthotics? I'm going to get fitted for those. Obviously, I don't know if they'll work, so I'm curious to know if they help others with similar symptoms. I know I'd rather try that than surgery! I have heard that the surgery isn't always helpful.
I did not get custom orthotics. My podiatrist suggested off the shelf ones to see if they would help before custom ones. I've had them for several years and wear them with my golf shoes, clogs, and sneakers. After the neuroma, he added a pad to the orthotic so that it would relieve pressure under the toes. This immediately gave me relief. I also found that certain shoes have this kind of foot bed. My dansko clogs and chaco sandals are great. I don't wear any orthotics with them. They completely alleviate any pressure near the neuroma.
I first got Morton's neuroma in my left foot around 24 y.o. I got the cortisone injection too (ow). It lasted me 4 years! I have high arches and also had custom orthotics made. Well, the MN came back. Essentially what they do is cut the tip of the nerve off that leads to the middle of the 3rd and 4th toe. I didn't know beforehand. I thought they were cutting out a cyst. But, it is way better than living w/the pain and/or those shots. Now, 10 yrs. later it popped up twice, but went away in a day or two. The Dr. had told me that basically our feet weren't designed to be in wedge sandals or walking on concrete, but on grass. Morton's won't go away on it's own. It's the only surgery I've ever had. It's a 1 1/4" scar, faint, and the numbness isn't total, and it's only on the underside and in between. My podiatrist is a woman, and I think she's more precise and delicate. Make sure yours is a thoughtful Dr. Good luck.
i am set to see someone for customr orthodics. did you ever have any luck for mortons neuroma with them? trish
I got off the shelf orthotics from my podiatrist. He added a pad behind the ball of my foot to alleviate pressure on my neuroma. It has helped quite a bit. I am having surgery in September. I'll see after that if I need any type of orthotics.
I don't know what your insurance situation is, but if you can, definitely get the custom ones from your podiatrist. They make a cast, and you get these semi-clear hard plastic orthotics from toe to heel (and I got 2 pair, one for work, one for home). It has like your name and a UPC code on them. They cost the insurance co. a lot, but they are totally worth it. It greatly helped the pain, b/c it helped provide support no off the shelf thing could b/c my arches are high, plus I have a flexible foot. I dunno, that's what the Dr's said. All I know is it helped, I love the way they feel, even though it sounds like they'd be UNcomfortable, they are not. B/c they're made for YOUR foot alone, not where anyone w/a pair of scissors can have the same effect. Get them. They're good for a lifetime. Unless your feet are gonna grow some more, they're the best co-pay I've ever paid. The surgery was smooth. Fast recovery. Time off from work. Small, light scar. Who looks? Good luck, and let me know how it goes, ok?
Last edited by moderator2; 08-25-2010 at 09:05 AM.
thanks so much...i see othodics guy this week and hope this saves me from surgery just because of the horror stories. i just can't believe the suffering going on out here with mortons neuroma and how uncaring so many of the surgeons are after bad results. anyway, fingers crossed. trish