<p>So my reward for pushing myself at the gym is a constant pain under the toes of one foot. The podiatrist has tentatively diagnosed a nerve swelling, Morton’s neuroma. A second possibility is an inflamed toe joint, but nothing appears on x-rays. He mentioned cortisone and surgery as options, but I’ve seen references to a newer treatment involving alcohol injections as an effective way to shrink the nerve. Has anyone had this condition and had it resolved? Did you get an MRI or ultrasound, or just rely on x-rays and the doctor’s experience? Thanks!</p>
<p>I had it consistently when I started exercising for the first time in decades. Walking triggered it – numbness/pain around the base of the middle toe.</p>
<p>I did two things:</p>
<p>a) Bought shoes that were wide across the toe box/forefoot and did not put any squeezing pressure on the toes – wide enough to freely wiggle the toes.</p>
<p>b) With the new shoes, started wearing SuperFeet insoles.</p>
<p>Not sure what combination did the trick, but the Morton’s Neuroma resolved itself nearly immediately after making those changes. Of course, it’s possible that just walking more, losing some weight, and getting in better shape was responsible. However, I have made sure to wear wide enough shoes and use SuperFeet insoles in all my shoes and hiking boots since. Never had another hint of the Morton’s pain for the three years since. I don’t even consider shoes or boots unless I can get a wide or an extra-wide size.</p>
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<p>A third option, that I never really tried, is a [metatarsal</a> pad](<a href=“http://www.performancefoot.com/81-333-thickbox/gel-metatarsal-pad.jpg]metatarsal”>http://www.performancefoot.com/81-333-thickbox/gel-metatarsal-pad.jpg) under the ball of the foot. Like the arch support in the SuperFeet insoles, these force the foot into more of an arched position, distributing the force away from the joints at the base of the toes. NewBalance makes an insole with an integrated metataral pad.</p>
![http://www.performancefoot.com/81-333-thickbox/gel-metatarsal-pad.jpg]metatarsal](http://www.performancefoot.com/81-333-thickbox/gel-metatarsal-pad.jpg%5Dmetatarsal){kind=link}
<p>BTW, I would not consider foot surgery except as a desperate last resort after eliminating every possible alternative solution. The nature of the foot – lots of tiny bones held in place by lots of tiny ligaments – just doesn’t lend itself to predictable healing. I would be concerned about going through intensive rehab only to end up no better off, or even worse off.</p>
<p>I had surgery for a Morton’s Neuroma about 20 years ago so I’m sure there are newer treatments. Mine was very large and made it difficult to walk w/o pain. If I hit it just right it would send a zap all thru my foot- almost like a jolt of electricity. I dont even remember having an x-ray but maybe I did. I believe he could feel it and just diagnosed it by experience. Surgery was successful- there was some numbness in my foot for a while but I eventually regained feeling. I was off my foot for a couple of weeks- it was pretty sore. After all this time, it has grown back although not nearly as large.</p>
<p>I had foot pain recently that my podiatrist suspected was Morton’s neuroma but never officially said that was what I had. I was supposed to be wearing prescription orthotics anyway to correct collapsing arches, and now that I am wearing those I am not getting the pain during exercise anymore most of the time. I still can’t seem to do the elliptical without putting too much pressure on the balls of my feet causing pain, but I can do anything else. If I wear my orthotics and don’t walk around the house without shoes on it’s enough for me. My doctor didn’t even mention anything else as a possibility until we tried this.</p>
<p>My podiatrist is one that is conservative about surgery and won’t perform it unless it really seems to be needed-- ie you are in pain and there are no other practical options. I’d be reluctant to consider surgery without trying other options first.</p>
<p>Helpful comments, thank you. I think this all started with a pair of bad shoes, insufficient cushioning and too small in the toe area. Also I should have alternated the elliptical with the treadmill and stationary cycle more frequently. I’ll check out the Superfeet insoles. I’ve found Croc’s provide relief, but don’t wear those outside my garden!</p>
<p>I had foot pain like you described last year. I went to a running store and had them fit me to running shoes that fit and were roomy in the toe box. They were not cheap but effective. I put inserts in also. Have not had foot pain since. </p>
<p>I do find that if I wear my flip flops too much that aggravates my foot pain. It hasn’t been flip flop season here but I’m going to try and lessen the time I wear them.</p>
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<p>These things are just stupid expensive, so I can’t really condone them. But, I now wear anatomically correct flip flops:</p>
<p>[Superfeet</a> Premium Insoles](<a href=“http://www.superfeet.com/sandals/]Superfeet”>http://www.superfeet.com/sandals/)</p>
<p>I had it when I was a big runner. I wish someone had told me to buy a shoe with a bigger toe box. I always wore really slim shoes because I have a narrow ankle. I stopped running because of the pain. :(</p>
<p>How exciting, Nordstrom showed up as a dealer for Superfeet products. Shopping at Nordstrom is now a medical necessity.</p>
<p>My mother used a metatarsal pad and had accupuncture when the cortisone injection no longer was effective.</p>
<p>For me, if this is what I’ve had, a bigger toe box shoe made a huge difference. </p>
<p>I found running / workout shoes that don’t attach the laces to front part of the shoe, so there’s much less pressure on the front foot when the shoe bends. I use Asics but now there are a number of varieties designed like this. That release in pressure helped.</p>
<p>I have this problem also. K-Swiss makes a wide toe box tennis shoe. Merrell sandals and trail runners are wide also. When I do get the pain, vigorous massage relieves it.</p>
<p>I have had problems with this in both my feet, and sometimes it felt like stepping on an ice pick!. What has managed it has been to wear soft-footbed birkenstocks. (The original soft footbed ones, not the hard footbed ones, not the birkis, or other brands.). The original soft footbed has a big metatarsal support,plus big arch support,plus soft foam and cork…forces your feet to spread out and takes pressure off the area. After years of wearing JUST those, in different styles, I now can wear some other brands, such as keenes and allegrias ( designed for nurses). I buy the expensive stickon metatarsal supports for non birkenstock shoes. (15.00$ for a stickon pad-seriously a rip-off!). I would avoid surgery and manage it by other means if possible.</p>
<p>Everyone in line to check in to podiatry was wearing Birkenstocks. I’ve been wearing them for 25 years (the original German monk style) which I think has made my feet more unforgiving of other shoes. I’m encouraged that most with this affliction seem to have dealt with it without invasive intervention. My doctor was throwing out so many treatment possibilities that I thought an injection would be inevitable. I guess I told him that I did not want to have swimming be my only exercise option, so perhaps he was trying to be reassuring. I’ll find out tomorrow what he has in mind, and I feel better informed now on the importance of orthotics.</p>
<p>I suffered from this years ago - how nice to find people who understand the pain! Anyway, I spent a total of a year at the podiatrist - first doing cortisone injections, which did provide relief but only for a short while - then he suggested alcohol injections - a series of three I believe. TALK ABOUT PAINFUL! That was followed up by months of ‘physical therapy’ which consisted of electricity pulsed through my feet. It never really went away, but I find if I keep rotating shoes (all wide toe boxes) and never wear heels, it’s not too painful. I tried the pads suggested for Morton’s neuroma, but found they actually aggravated the situation. I’m happy to hear the recommendation for Superfeet insoles - I’ve never heard of them.</p>
<p>If I understand correctly, metatarsal pads are supposed to go behind the area where the pain is to support the front of the arch and relieve pressure from the ball of the foot, rather than going directly under where the pain is. Since orthotics without any kind of particular metatarsal padding virtually solved my problem, it seems logical to me. Make sure if you try pads that you are placing them correctly.</p>
<p>Had my visit to the podiatrist again yesterday. He is not convinced it is a neuroma, and said that the joint in the second toe appears slightly dislocated in the xray. Apparently the nerve is adjacent to the joint, so it’s very difficult to differentiate the cause. He injected a small amount of cortisone directly into the joint, and I think it has helped already. He cautioned that cortisone can make joint problems worse by causing atrophy in the soft supportive tissues, so this is a “one time” trial. I’m also supposed to tape the toe down every morning to prevent it from flexing too much. He keeps mentioning surgery if the joint is the problem, but I think I’d like to be very conservative and try all the orthotics first. I asked about ultrasound to help in the diagnosis, and he laughed and said our HMO does not offer that option. I’m not sure why feet are treated as second class citizens, not worthy of the technology available to other parts of the body. </p>
<p>mom22girls, thank you for sharing your experience. It doesn’t sound like the alcohol injections are the panacea that some of the medical sites suggest. I think I need to take up swimming.</p>
<p>Thanks to the suggestions here. I get the Morton’s neuroma pain when hiking so I went to REI and got the Superfeet insoles. (REI assured me that even if I cut the insoles down to fit my boots and cut out a little hole around where the neuroma is I can still return them if they don’t relieve the pain). So there’s no risk. The insoles are around $35 with a 20% off sale going on now.</p>
<p>I had the surgery many years ago, because I could hardly even walk. I remember the podiatrist cut out a hard ball of something from between two of my toes. The recovery was short- no bones were involved. The area is still numb because he cut the nerve endings, but it’s just a small spot between my toes, so it doesn’t affect me in any way. I switched to Easy Spirit shoes and haven’t had a problem since. I tried the orthotics, but Easy Spirit works for me. No more going barefoot or wearing flip-flops! I never have worn high heels, so that wasn’t a problem.</p>