49 replies to this topic

[Wombat Chuck]

Hi folks,

Just wondering how anyone who has a Morton's Neuroma (very basically a numbness in the front outside quarter of the foot caused by a pinched nerve) has treated it. I've had mine for the best part of a year or so and it has simply been irritating, but recently it has started to cause discomfort when running. I'm not a huge fan of orthotics, but I think that may be my only option... anyone?

Cheers
Chuck

[DrJH]

You could try a cortisone injection. If your diagnosis is right they sometimes require surgery.

[Wombat Chuck]

Thanks JH, I've heard about the cortisone thing - is that an actual cure potentially, or more of a short-term pain relief approach?

Cheers
Chuck

[DrJH]

It can be a cure. Often once the inflammation has settled the pressure eases and the whole area improves. Like anything, results can vary though.

[Lynde]

Two and a half weeks out from my first marathon and I have been diagnosed with having Morton's Neuroma. Seems to have happened because I borrowed my daughters shoes to do a track race in the weekend before last. I noticed a slight numbness in my toes when I pressed on the ball of my foot and I have the cluck you get when you squeeze your foot. Anyone have any helpful suggestions for getting me through the next couple of weeks and the Marathon ?

[courtlylove]

Sorry - can't give any help to those wanting quick relief. I had a Morton's Neuroma for over 10 years before it was diagnosed. It was agony. I finally had it removed surgically 22 years ago and have never had a problem since. The only side effect of the surgery was numbness in the inside of the toe closest to the neuroma. A small price to pay for the relief from the pain.

CL

[Lynde]

Thanks anyway courtlylove as long as I can get through the marathon without causing any serious long lasting problems I'll be happy.   :D

[Bert]

I had two neuromas in one foot and one in the other,( at separate times). For the first one I had the Cortisone and Pethidine injections several times. The injections do work, but in my case at least they wear off after some weeks to months. The first one lasted about three months, then each one lasted progressively less time.
If you do have a neuroma it feels like your toes are on fire, and the pain progressively returns after the treatment.
You will probably need to see a foot specialist for the injections or otherwise have them done with ultrasound guidance, as they need to be placed accurately.
Eventually I had the surgery done, first one neuroma, then the other two. It consists basically of cutting the affected nerves to the toes. It does leave some numbness in the toes, but I soon got used to that. You do need to use a little more care when walking around barefoot.
When the pain was at its worst I couldn't run 5km. Two weeks ago I ran Six Foot. After the single operation I ran an easy 5km race at Homebush Bay 8 days later.
I wish I had had the op sooner, but the injections will get you through a marathon if you have them done a week or two beforehand.

[Ellie80]

i have one of these and it was aggravated for me by wearing shoes that were even slightly too narrow or high heels putting pressure on the balls of my feet. It was so painful!!! But in a happy ending, an orthotic with a dome thing that keeps the bones spread out, worn only in my running shoes has completely eliminated all pain. i still can't wear super-high or narrow shoes but probably wouldn't anyway.

not the answer you wanted re orthotics, and not so useful prior to a marathon, but there is a possibility of fixing it without cortisone or operations if you get it early!

[chris_decath]

i say visit a podiatrist, im a pod student and we have talked about this you can use like muscle manipuation (massage), or even a use of a pad to seperate the mets to give a great area for the nerve to pass though. but go see a pod!!

[southy]

TRy icing it after running and using some antiinflammatories. I had one that went away by using ice and taking about 10 days of anti-inflamatories. I'm now careful to try to not wear shoes that are narrow. I got mine racing a 10k road race in a pair of road racers that were a bit narrow (my feet seemed to swell a bit during the race).

[Boonarga]

I've just been to see a doc who, after a cursory exam where she barely touched the foot, diagnosed a possible bone spur. Since then I googled on it and all the symptoms seem to fit Morton's Neuroma.
Can it be diagnosed via x-ray?
Would a cortisone injection see me through a 100 mile race?
Should I just put up with it with the help of painkillers?

Whatever it is, it's bloody painful!!

[DrJH]

Assuming you have a neuroma, ultrasound can be used to confirm the diagnosis and guide the injection. Bear in mind cortisone injections require an abreviated therapeutic use exemption form if it is used in competiton. Ideally you would do it well before as cortisone will work its effect over a couple of weeks.

[BigCol]

Boonarga, on Jul 25 2006, 07:20 AM, said:

Whatever it is, it's bloody painful!!

My oath it is! I played basketball with one for nearly 3 years. Like others here I had it surgically removed 10 years ago: no pain now but was damn painful during recovery / rehab, and the downside is that I have 2 numb toes on top, bottom & in between.

But on the positive side it makes walking around in barefeet in summer heaps easier!!

Edited by BigCol, 25 July 2006 - 07:26 PM.

[BEN-HUR]

If the pain is between the 3rd & 4th toes & sometimes between the 1st (big toe) & the 2nd toes then it is most likely a Neuroma. If it is felt particularly when kneeling down or when toes are hyper extended, then this is another sign that it could be a Neuroma. There is also the crunch test - squeezing the toes or ball of foot together can elicit pain. The pain is usually of a burning ache, sharp shooting or numbing variety. Basically it is the Medial Plantar Nerve being impinged by the Transverse Metatarsal Ligament which can be  caused by a variety of reasons. This nerve then becomes inflamed/thickened thus leaving it more pronounced to be impinged in the future.
My recommendations from a Podiatry point of view to treatment is to start with a more conservative option & if unsuccessful then have the cortisone injection & then possibly surgery.
Options:
-a wedge made to fit between the toes where pain is present to separate the offending Metatarsals & Phalanges (toes).
-Whats known as a pontoon or metatarsal dome placed in footwear or on insole to raise a Metatarsal or support the transverse metatarsal arch.
-Orthotics - to resolve the possible cause of the problem i.e pronation - to reduce excess motion & aid support of structure thus alleviating soft tissue trauma i.e Medial Plantar Nerve.
Hope this helps!
Regards... BEN-HUR

[bboywannabe]

http://www.tampacryosurgery.com/ (video also here if you scroll down a bit)

Article Comparing Alcohol Injections to Cryosurgery
http://www.podiatryt...om/article/2691

I'm seeing a lot of surgery horror stories. You should consider and research cryosurgery before you take the plunge.

Alcohol

-alcohol causes tissue irritation, and ulcers or abscess may occur - can be very painful
-may cause formation of stump neuroma
-4% concentration of alcohol sometimes not strong enough to cause chemical neurolysis

Cryosurgery

-minimally invasive and takes approximately 15 minutes to perform
-no incidence of stump neuroma formation
-short postoperative recovery period - only need to reduce activity for few days
-success rates with one treament run 80-90%.
-cryosurgery can be repeated without problems
-available for heel pain, Morton's neuroma, plantar fasciitis and many other painful foot conditions and masses

[Boonarga]

I hope that this is the fix I've been looking for.

[Uncle Dave]

FWIW, I used a metatarsal dome as mentioned by Ben Hur, which I only got onto after a month-and-a-bit of farting around chasing x-rays and bone scans as the physio suspected a stress reaction. The podiatrist got me onto the dome and I wore it for three weeks. Came straight out of it and hit the ground running...unfortunately, me being the stupid bugger that I am, stuffed my other foot up in a seperate problem, and am now not running again, but the point is, the dome did exactly what the pod claimed, and I was happy with it. That foot had no dramas going straight into big miles again, though there's a lot to be said for a more conservative approach...

Hope you get your issues sorted soon.

Unc

[k_run]

There are also some tapping techniques that can to help reduce pain in the short term. If tapping is successful it indicates that foot orthoses with a metatarsal dome may be successful. The orthoses and metatarsal dome work by separating the metatarsal bones and thereby reducing compression of the neuroma, which causes the pain. Wider footwear (not just running shoes) is also important. If all conservative options fail then surgery is the way to go. The most important thing is to get the correct diagnoses.

Good luck

[lisac]

BigCol, on Jul 25 2006, 04:25 AM, said:

My oath it is! I played basketball with one for nearly 3 years. Like others here I had it surgically removed 10 years ago: no pain now but was damn painful during recovery / rehab, and the downside is that I have 2 numb toes on top, bottom & in between.

But on the positive side it makes walking around in barefeet in summer heaps easier!!

I just had neuroma surgery on my right foot and one week post op I can't believe how much it still hurts, can you tell me at what point you were able to walk without alot of pain?  I can't even touch my foot without seeing stars.

[Lilumo]

My orthopaedic surgeon suggested cortisone for neuroma, but I am not keen on it. Has anyone heard of or had any experience with a natural anti-inflammatory enzyme called serrapeptase?

[CliffyB]

I had the cortisone injection as well as prescribed anti inflams. It didn't work so I had to have ultra sound guided cortisone injections. This process had to be repeated two times but it was successful in hitting the spot. I couldnt run for a while and was more cautious to not redo any more damage. I now also wear orthotics (not when running) and had a metatarsal dome put on to put pressure on the spot. This was my preferred option as I wasnt too keen on losing any nerves. Anyway this problem is now fixed (touch wood). Girls usually suffer from this from wearing high heels. Andrew Mcleod from the Adelaide Crows also suffered from this.

Edited by CliffyB, 28 November 2008 - 12:14 PM.

[tracknut]

I'm pretty sure I have developed a mortons neuroma. I wore a new pair of spikes a few weeks ago that felt a little tight at the time and ever since then I have had this tingling sensation going to my 4th toe. I have no sharp stabbing pain and I can run pain free but I have to wear shoes that are not too narrow. I need to get back into spikes soon and I'm just wondering what I should do? I noticed from doing a bit of a search that this can develop into a serious problem and I would like to avoid that. When I press down on the space between my 3rd and 4th toes it refers symptoms to the 4th toe. Would a metatarsal pad be appropriate? Should I be taking antiinflamms? Like I said at the moment it is not very painful but just annoying and I could continue to train with it but would like to get rid of it heading into heavy winter training

[maryclaire]

I had an ultrasound today and was told there is no sign of neuroma.  This is despite numbness in underside, fleshy pad of 3rd and 4th toes on R foot.  The numbness came on suddenly one day, and was during a period of little running, so I can't really believe it is running induced in my case.  

My GP sent me to neurologist to check it out as the medical profession do not like to see unexplained loss of feeling.  Perhaps you should get yours checked out.  I was simply told that myabe running is not for me, given my foot structure.  I felt this was a stupid comment, as I was still left with no explanation for the numbness, nor any plan for getting rid of it.  

I currently have a dome under my metatarsals to raise them and hopefully free up the nerve in there.  It's only been in 2 days so i can't say there's any improvement yet.

Good luck.

[Whippet Man]

Tracknut I'll leave the best management options for one of the pods but I wanted to point out to maryclaire that ultrasound is not always definitive with neuromas. Sometimes accessibility is limited in the narrow space between the metatarsal heads (which is when you are more likely to actually have a problem) and there is also a significant operator dependency. A good clinician (preferably one sympathetic to a runner) is important. Good luck to both of you.

[BEN-HUR]

tracknut, on Apr 3 2009, 02:20 PM, said:

I'm pretty sure I have developed a mortons neuroma. I wore a new pair of spikes a few weeks ago that felt a little tight at the time and ever since then I have had this tingling sensation going to my 4th toe. I have no sharp stabbing pain and I can run pain free but I have to wear shoes that are not too narrow. I need to get back into spikes soon and I'm just wondering what I should do? I noticed from doing a bit of a search that this can develop into a serious problem and I would like to avoid that. When I press down on the space between my 3rd and 4th toes it refers symptoms to the 4th toe. Would a metatarsal pad be appropriate? Should I be taking antiinflamms? Like I said at the moment it is not very painful but just annoying and I could continue to train with it but would like to get rid of it heading into heavy winter training

Hi tracknut,

The signs & symptoms of your account certainly sound like a Neuroma. Anti-inflammatories are of little benefit. The cause needs to be addressed. For starters...

1/ The spikes: they seem to be too narrow for your foot type. Instead of having to purchase new ones which are broader at the forefoot it may be best to first trying to broaden/widen the forefoot area of the spikes via pouring hot water over them, waiting for the water to cool a bit & wearing them. This may stretch the material around the forefoot to a degree which may prevent the compression of the metatarsals/phalanges (toe bones) onto the nerve.

2/ Metatarsal Dome (pad): these can be very effective as they lift up the metatarsal shafts & subsequently the Metatarsal Phalangeal Joint thus reducing the chance the offending nerve being impinged. However, the addition of a met. dome in the spikes may also contribute to less space for your forefoot in the shoe due to the added material, thus the combination of the above point followed by this option could be the best solution.

3/ Inter-digital wedge: this is a piece of material (usually of a silicon/rubber type material) fitted between (in your case) the 3rd & 4th toes to separate/widen the space between the phalange/metatarsal heads thus preventing impingement of nerve. One again, this contributes to a little extra bulk in forefoot, thus widening the forefoot region of spikes (point 1) could be needed in association with this option.

Here is a picture to give you an idea what is happening & what the above options could do...


Also the following is another post relating to another Neuroma issue which may give you more insight into the condition...

Quote

QUOTE (BEN-HUR @ Jul 25 2006, 09:12 PM)
If the pain is between the 3rd & 4th toes & sometimes between the 1st (big toe) & the 2nd toes then it is most likely a Neuroma (tends to be more prevalent in women due to footwear & child bearing years). If it is felt particularly when kneeling down or when toes are hyper extended, then this is another sign that it could be a Neuroma. There is also the 'crunch test' - squeezing the toes or ball of foot together can elicit pain. The pain is usually of a burning ache, sharp shooting or numbing variety.

Basically it is the Medial Plantar Nerve being impinged by the Transverse Metatarsal Ligament via narrowing between the Metatarsal Phalangeal Joints which can be caused by a variety of reasons (i.e. footwear - high heel &/or too narrow at forefoot). This nerve then becomes inflamed/thickened thus leaving it more pronounced to be impinged in the future.

My recommendations from a Podiatry point of view to treatment is to start with a more conservative option & if unsuccessful then have the cortisone injection & then possibly surgery (last option).

Options:
-a wedge made to fit between the toes where pain is present to widen the space between the offending Metatarsals & Phalanges (toe bones).
-What's known as a pontoon or metatarsal dome placed in footwear or on insole to raise a Metatarsal or support the transverse metatarsal arch (if there truly is such an 'arch' or perceive there to be in light of one's interpretation - anatomy debate).
-Orthotics - to resolve the possible cause of the problem i.e. pronation - to reduce excess motion & aid support of structure thus alleviating soft tissue trauma i.e. Medial Plantar Nerve.

Hope this helps!
Regards... BEN-HUR

This post was submitted in light of cortisone & surgery being mentioned in another Neuroma thread - these can be successful, however don't address the underlying cause.

I think it would be best getting a second opinion from a sport orientated Podiatrist.

Edit Reason: my Neuroma picture vanished... thus put a new one up  

Edited by BEN-HUR, 06 July 2010 - 08:50 PM.

[tracknut]

Thanks Ben-Hur for the advice. I really apprecaite it. Although the pain is not getting worse the tingling is getting more severe. I definetly get more relief when I put something in between my 3rd and 4th toes but the metatarsal dome seems to do little. Am I right in placing it about 1.5cm below the point that when I push on causes symptoms? I started on some antiinflamms and they don't seem to be doing anything like you suggested so I think I will cease them. How long would you suggest sticking with trying to treat it conservatively before going down the cortisone approach? I am just worried the increased tingling is a sign the nerve is becoming more inflamed and I don't want it to get to the stage that surgery is required. I can still run without symptoms but it just seems when i am walking around and when i attempt to lift my toes off the grund that the nerve either catches or gives me a tingling sensation

[maryclaire]

I am confused about a neuroma - firstly, how are they diagnosed???  My GP was curious that I have been diagnosed by a pod. simply by my symptoms - hence his referral for ultrasound.  And secondly, the GP was very specific that if a neuroma is diagnosed, it needs to be "excised" (his words).  Yet my reading here implies that a pad or dome is sufficient treatment to manage symptoms or possibly even deal with the neuroma itself.  Is it true that a neuroma needs to be removed?

Thanks.

[BEN-HUR]

tracknut, on Apr 5 2009, 10:23 AM, said:

the pain is not getting worse the tingling is getting more severe. I definetly get more relief when I put something in between my 3rd and 4th toes but the metatarsal dome seems to do little. Am I right in placing it about 1.5cm below the point that when I push on causes symptoms? I started on some antiinflamms and they don't seem to be doing anything like you suggested so I think I will cease them.

Yes tracknut, this is consistent with the symptoms of a Neuroma. The placement of the Met. Dome is pretty much directly behind the Met. Heads - you may have to move the Met. Dome around a bit to try & find the right spot for your foot before giving up on this option as it is crucial you have the placement pretty much exact, which will vary from person to person i.e. try 5-10mm behind the Met. Head or symptom area.

tracknut, on Apr 5 2009, 10:23 AM, said:

How long would you suggest sticking with trying to treat it conservatively before going down the cortisone approach? I am just worried the increased tingling is a sign the nerve is becoming more inflamed and I don't want it to get to the stage that surgery is required. I can still run without symptoms but it just seems when i am walking around and when i attempt to lift my toes off the grund that the nerve either catches or gives me a tingling sensation

It depends how long you have had the symptoms already & how frequent the symptoms are (thus the frequency of the irritation). The more frequent the irritation the more likely the offending nerve is at a state which is 'thick' enough to warrant more invasive action. This also will vary from person to person. In most cases resolvement is pretty quick i.e. within a few days, if however the symptoms are present for two weeks of trying the above mentioned options then a definitive diagnosis would be beneficial (i.e. via ultrasound) to confirm if a Neuroma is present or not, & if so, exactly where it is & how large it is.

maryclaire, on Apr 5 2009, 04:19 PM, said:

I am confused about a neuroma - firstly, how are they diagnosed???  My GP was curious that I have been diagnosed by a pod. simply by my symptoms - hence his referral for ultrasound.

No disrespect to your G.P but he probably hasn't come across to many Neuromas' & been involved with the process of treating them. Diagnosis is pretty much due to the specific unique signs & symptoms that they characteristically display i.e. like tracknut's & the following...

Quote

QUOTE (BEN-HUR @ Jul 25 2006, 09:12 PM)
If the pain/sensation is between the 3rd & 4th toes & sometimes between the 1st (big toe) & the 2nd toes then it is most likely a Neuroma (tends to be more prevalent in women due to footwear & child bearing years). If it is felt particularly when kneeling down or when toes are hyper extended, then this is another sign that it could be a Neuroma. There is also the 'crunch test' - squeezing the toes or ball of foot together can elicit pain. The pain is usually of a burning ache, sharp shooting or numbing (tingling) variety.

Basically it is the Medial Plantar Nerve being impinged by the Transverse Metatarsal Ligament via narrowing between the Metatarsal Phalangeal Joints which can be caused by a variety of reasons (i.e. footwear - high heel &/or too narrow at forefoot). This nerve then becomes inflamed/thickened thus leaving it more pronounced to be impinged in the future.

Diagnostic imaging i.e. ultrasound is rarely necessary. Why not get to treating the symptoms first ASAP where relief can be noted very soon afterwards (i.e. few days - week) & if symptoms disappear we know exactly what it was. However if symptoms persist after about two weeks of applying the conservative options then get an ultrasound.

maryclaire, on Apr 5 2009, 04:19 PM, said:

And secondly, the GP was very specific that if a neuroma is diagnosed, it needs to be "excised" (his words).  Yet my reading here implies that a pad or dome is sufficient treatment to manage symptoms or possibly even deal with the neuroma itself.  Is it true that a neuroma needs to be removed?

The conservative options as stated are all that is usually needed. Surgery is only needed if these options as well as the cortisone haven't been effective & an ultrasound reveals that the Neuroma is quite large. You don't want to go through surgery if you can help it (avoid scar tissue & possibility of reduced neural sensation to offended region).
Note The Ten Laws Of Running Injuries: particularly laws 4,5,6 & 9.

Quote

Ten Laws of Running Injuries stated therein:

1ST LAW - Running Injuries Are Not an Act of God.

2ND LAW - Each Running Injury Progresses Through Four Grades:
- Grade I injuries are those which cause pain only after exercise, and are often felt some hours after exercising.

- Grade II injuries cause discomfort, not yet pain, during exercise, but not enough to stop the person from training.

- Grade III injuries cause actual pain, which limits the person's training and race performance.

- Grade IV injuries are so severe that running is not possible.

3RD LAW - Each Running Injury Indicates That the Athlete Has Reached the Breakdown Point.

4TH LAW - Virtually All Running Injuries Are Curable.

5TH LAW - X-Rays and Other Sophisticated Investigations Are Seldom Necessary to Diagnose Running Injuries.

6TH LAW - Treat the Cause, Not the Effect

7TH LAW - Rest is Seldom the Most Appropriate Treatment

8TH LAW - Never Accept as a Final Opinion the Advice of a Nonrunner.

9TH LAW - Avoid the Knife.

10TH LAW - There Is No Definitive Scientific Evidence That Running Causes Osteoarthritis in Runners Whose Knees Were Normal When They Started Running.

[maryclaire]

thanks, BenHur - the info you post and re-post (I accept that I am slow here) is valuable.  The only real symptom i have is numbness on the 4th toe, occasionally extending to the 3rd and some tingling that I can't put any sort of pattern on.  The pinch tests are all pain-free.  

I am so fed up with my R foot which is the cause of my non-running at the moment.  I think the neuroma is a side issue, but can't help but think that given the right foot's plethora of problems, they are all inter-related somehow.  The left foot is completely happy.  

Thanks again for your time and input.  I particularly like the 9th law.

[BEN-HUR]

maryclaire, on Apr 5 2009, 08:02 PM, said:

I think the neuroma is a side issue, but can't help but think that given the right foot's plethora of problems, they are all inter-related somehow.  The left foot is completely happy.

Yes, I agree - I think there is a link there also. This can only be worked out via a biomechanical assessment & addressing the cause. I am sure all will eventually fall in place. All the best.

[tracknut]

Hi Ben Hur. I was just wanting to get some further advice from you. After a few weeks continuing with the Met dome and toe separator things were not improving. I went and saw the sports doc who ordered a ultrasound and cortisone if a neuroma was present. The ultrasound confirmed the neuroma and I had a cortisone injection. That was 4 days ago and my symptoms seem to be completely the same.
I am wondering where to go from here. My dr suggested the surgery if the cortsione failed to work. I am nervous about this measure as I have read lots of stories of the pain returning worse than ever.
There seems to be a lot of overseas information suggesting alcohol injections into area but there does not seem to be a lot of information about this in Australia. Do you have any experience with this or what avenue would you suggest from here?
Many thanks

[runwithdogs]

I had a Morton's neuroma about 15 years ago. I had a cortisone shot to carry me through until I could arrange a couple of weeks off work after surgery. I think these days they cut through the top of the foot, but I had my incision through the bottom of my foot, so I was on crutches for about two weeks. Since then, no more neuroma pain, it was completely curative. So, the knife isn't always a bad thing.

I still have issues with my feet but they're not neuroma related.

Edited by runwithdogs, 27 April 2009 - 12:47 PM.

[Simmo]

Hadn't come across the 10 laws before so I googled them.
This site http://www.coachr.or...ng_injuries.htm lists them with much more (and very interesting and useful) detail.
As an aside that is relevant to this topic, under law 9 it actually states "The only true running injuries for which surgery is the first line of treatment are muscle compartment syndromes and interdigital neuromas."

[BEN-HUR]

tracknut, on Apr 27 2009, 10:10 AM, said:

Hi Ben Hur. I was just wanting to get some further advice from you. After a few weeks continuing with the Met dome and toe separator things were not improving. I went and saw the sports doc who ordered a ultrasound and cortisone if a neuroma was present. The ultrasound confirmed the neuroma and I had a cortisone injection. That was 4 days ago and my symptoms seem to be completely the same.
I am wondering where to go from here. My dr suggested the surgery if the cortsione failed to work. I am nervous about this measure as I have read lots of stories of the pain returning worse than ever.
There seems to be a lot of overseas information suggesting alcohol injections into area but there does not seem to be a lot of information about this in Australia. Do you have any experience with this or what avenue would you suggest from here?
Many thanks

Hi tracknut,

It would seem to me that the neuroma is quite large for it not to respond to the above conservative treatment options. I take it you were guided as to the use of the Met. Dome & Interdigital Wedge. Was a biomechanical assessment performed to find if a possible cause to any adverse movement related issues present? If there was (i.e. excess out phase pronation) was this also addressed? If so, then unfortunately more invasive options are required as the neuroma would seem to be quite large.

In regard to the surgery, I am not aware of "lots" of bad outcomes. You will get varying degrees of success due to varying circumstances. The success rate is quite good as far as I know. All the patients I have come in contact with in regard to this procedure have responded well... some however may experience lack of sensation in the region (due to nerve being cut). From what I have read there seems to be a better outcome with the alcohol injections.

I am not too familiar with the alcohol injections, particularly in this country. I have read they have been very successful. Have you asked your G.P about this option or probably more appropriately ask the Orthopaedic surgeon about this option. I assume it was an Orthopaedic surgeon who gave you the cortisone injection. At this point in time I can't tell you anymore about this procedure.

I briefly skimmed over another forum relating to neuromas. I believe it is the U.S version of CoolRunning... link. Here you would probably get an unbiased opinion on the topic.

Simmo, on Apr 27 2009, 03:06 PM, said:

Hadn't come across the 10 laws before so I googled them.
This site http://www.coachr.or...ng_injuries.htm lists them with much more (and very interesting and useful) detail.
As an aside that is relevant to this topic, under law 9 it actually states "The only true running injuries for which surgery is the first line of treatment are muscle compartment syndromes and interdigital neuromas."

Whilst I agree the above conditions a hard to conservatively treat particularly if left too long, I still personally wouldn't recommend surgery as the first line of treatment.

[ican]

Just wanted to BUMP this and ask for the details of any sports related podiatrists that can assess and treat this condition.  I suspect I have it and it only affects me for the first few k's of a run after which point it settles.  I wanted to get it checked out though.

EDIT:  sorry should've mentioned I'm in the Northern suburbs of Melbourne.

Edited by ican, 17 June 2009 - 02:07 PM.

[apricots]

This  is hugely interesting to me, because I think I have on of these blasted things too.   (Haven't looked into CR for ages, so have probably missed all sorts of good things)

For about a fortnight or more, I've had this burning pain from between my 3rd & 4th toes on my left foot, going back towards the ball of the foot.   Fine when doing nothing, but it hurts on and off when I walk about doing my non-running jobs.   Outdoors I wear elastic sided riding boots which are nice and broad (I "do" horses as well as distance running)  Indoors, I wear flip-flops, because I don't find walking on hard floors comfy, due to loss of padding on the undersides of my feet.    When I go out, I wear fashion shoes, but they're not terribly constrictive, especially if I have to do much walking.   So I do try to look after myself.

This problem coincided with starting a new pair of runners - they felt fine in The Athlete's Foot (got measured and all), but after running 8km in them, I realised that when my feet expanded a bit, they were half a size too small.    Got a black toenail on my third toe (left/problem foot) and about a third of a black toenail on that big toe.    Ever since, I've put aside those lovely shoes and used a new larger pair - two pairs actually, but I think one is more comfy than the other - with padded insoles.  

What maddens me is that running hurts!  (Well, often walking in boots or flip-flops does too)   I normally train every second day, over 12.5km with a couple of hills in it, but it hurts for about the first couple of km, then it's ok.    Resting or doing nothing hasn't really helped that much, and as I said, when I'm just slowly pottering about, it's mostly fine.    I have a serious aversion to medicos of any ilk, and tend to ask our vet for advice, which a lot of people  find very amusing (he does too, but is a very nice chap)    I'll run on through pain rather than comtemplate any sort of surgery.  I think I have quite a high pain threshold.

I bought a metatarsal pad, and while it gave instant relief for walking about, I found it was awful for running - perhaps because it couldn't stay in the proper position - so it may have made matters worse.      I ran about 7km before it went from uncomfortable to agonising, perservered for 3km more before the pain was too much - think a large horse standing on your foot crossed with a red-hot poker being applied.    Then I sat down and pulled the pad off, and resumed running - INSTANT RELIEF!    But now the conditon is just stagnant.    Not really getting any worse, but not getting any better either.  I have the Tamworth Ten next Sunday, have my entry in and all.... and am b****y determined to run, if it half kills me.      No, I'm not a sensible person - I do horses, remember?
I've found Ibuprofen is useless - any suggestions of a better painkiller that's available over the counter?     I'm not bloomin' giving up.  

I've found Ben Hur's posts here very informative.   Of my five running books, only ONE mentions Morton's Neuroma, and I've learned heaps more from this thread than from the book - it was far too brief.  If anybody has anything helpful to say, please do.

[SoLucky]

Ben Hur has been very comprehensive in his descriptions of cause and treatment of Mortons Neuroma.  All that I can add to the subject is some info on my personal experience with the painful ailment.
Like you and Tracknut, I found that the problem became apparent when I bought a new pair of shoes. Within a couple of days I was feeling sharp pain between the 2nd and 3rd toes on my right foot, and it was bad when just sitting quietly with my shoes on. The worst circumstance seemed to be when travelling on an aircraft with limited room to move my legs.
A larger size in shoes relieved the condition but I took myself to a podiatrist to have it checked out.  Because I had always regarded myself as having a neutral gait, I was surprised when he recommended orthotics to control pronation plus a met dome on the offending foot.
Result?  No pain at all while running, and a very big improvement when wearing my street shoes (no orthotics).  It may be that using the dome has had a corrective effect on the impinged nerve situation.
Apricots,  I suggest that you consider widening your treatment options away from your farrier and vet.  I really hope that you can get as positive a result as my pod achieved for me.

[apricots]

Well, it's good news today from me at any rate..... had a busy day yesterday, driving, walking & sitting, and decided to wear the metatarsal pad on my left foot (the one with the suspected MN)  After a while I took the pad off because it was causing even more pain.  In fact my foot gave me gyp most of the day, but when I woke up this morning, the pain had disappeared.   I was amazed.   What did I do?   This hasn't happened since the problem reared its ugly head, so I was tentatively hopeful.  

Did my horse jobs, rode the young one I'm breaking in for about 45 minutes, then finished up in the barn and went for a run - 12.5km.   Slight discomfort for the first couple of km, then nothing!    Did the endorphins kick in?   Dunno!   When I got back, I felt fine, but popped a couple of panadol just in case, but have felt fine all day.   Wow.   Tamworth Ten, here I come!  

One thing I definitely have noticed is that my feet expand as they warm up, so I have to be very careful not to do my shoelaces up too tightly.   In fact, I have to have them a little bit loose to start with, or else they end up too tight, but in the buzz of running, I maybe don't notice..... till I finish and then it's too late, if my feet have been half strangled during the run.

[PhysioAdvisor]

Hi all, thought some of you might be interested in checking out the following link to detailed information on my website regarding mortons neuroma or metatarsalgia:

Mortons neuroma

Hope you find that useful,

[eastodlux]

I had this issue last year and it went undiagnosed for so long. Eventually I was referred for ultrasound and, just out of sheet luck, ended up seeing someone who specialised in feet at the imaging clinic I visited - within about two seconds she suspected neuroma. Alcohol injection solved the problem for me. If anyones interested, I visited these guys (in Melbourne).

[southy]

what does an alcohol injection do?

[bones]

I've been suffering from this for a few weeks; at first I thought it was related to piriformis pain, but my physio was quick to diagnose. He has me using a dome (replaced daily) on the sole of my foot, strategically placed, to push the toes apart, ice, and voltaren gel patches (globs of the gel with tape over to keep it from rubbing off). Since treatment only started on Monday, I can't expect a sudden cure, but I'm hopeful.

[eastodlux]

southy, on 04 March 2011 - 09:59 AM, said:

what does an alcohol injection do?

As far as I know, it just zapped the nerve. I'm pretty sure it's 100% alcohol. I wonder if you're safe to drive afterwards...

Keep in mind, I'm the least clinical person around, so my explanation might leave lots to be desired.

[HeidiM84]

Mortons neuroma surgery is supposed to be quite effective, but with anything you don't want to go rushing into it. Instead try everything else first. The most common causes are overpronation and wearing tight trainers. Try a wider fitting pair. Get a gait analysis to make sure you have the right ones.

[Kirko]

I had mortons neuroma and my physio put a metdome into my shoes straight away and haven't had issues since except for a short period where i decided I was going to do all my running in my racing flats without my orthotics. I smartened up got back into the right shoes and no issues since

[Chelbub]

I am bumping this thread up as it possible I have this....awaiting an xray and ultrasound in a week or so....

Some good info on this thread and it looks like I may have to rest for the next week...I think mine is in the early stages and I am hoping to get it fixed before it becomes worse...possible cause -- long trail run with some fierce downhills in shoes that were not super old but needed replacing...and maybe the new shoes aren't right??

I think I will book in to see a podiatrist asap...I have too many goals for 2012 to be sidelined by an injury!

Rach

[RunningMum11]

Maybe this horrid thing is causing pain in my feet too .. yes both of them are hurting as I type ..the pain started in earnest after my training run on Tuesday .. I really want to do my training run tomorrow for C25K - Week 4 - workout 3 but not sure if that will make it worse.

My feet have been "burning" most of the evening and it hurts to walk .. I know I need new shoes but haven't received them yet. I wear custom orthotics most of time - I swap them from shoes to my old ASICS 1130 runners while I wait for the Kayanos to arrive.

So sorry for the long winded story but my query is

1. Do I do my 3rd workout on Saturday but say on grass rather than on the footpath I've been using for most of my recent runs? OR
2. Do I rest for a week and do Week 4 again next week? OR
3. Do I go see a podiatrist and get some advice?
4. Or some other option that someone more experienced can suggest?

Please help .. really really really want to run..

[Chelbub]

Hi Runningmum 11,

I can't really give you any advice since I am only in the initial stages of diagnosis but physio advisor put on a really useful link http://www.physioadv...ysioadvisor.htm - he didn't do it this way but I am technically challenged at putting this sort of thing on line - if you look at his earlier post the link is there.

It would appear that it is probably best not to run until it is diagnosed and treated - I am going to try a short run on monday and if I pull up sore than I wont run until treated.  I am trying to be sensible because I don't want to exacerbate the problem.  I would see a podiatrist or your GP - my GP has ordered an Xray and Ultrasound and depending on the results will then refer me to a podiatrist.  I am going to book into a pod on monday because there is usually a wait list so rather than wait to be referred I shall plan ahead!  

In regards to the Kayanos - I wear them as well but the last model ordered half a size larger because the toe box appeared to be smaller.  This current model I have gone back to my original size as the assistant told me I should but I am wondering now whether I should have gone half a size bigger again given that part of the treatment for this problem is a wide toe box in your shoes.  I can't say the new shoes have caused it though but may be exacerbating it...hopefully the pod can answer that question...

I hope this is of some use to you and good luck!  But I have learnt and continually am learning that any injury needs to be treated quickly rather than ignored as it usually turns into a bigger problem that could be avoided.  I am sure you are probably really keen to keep with the program but maybe keep walking until it is sorted out.

Another thing,  I am avoiding hills until it is fixed because this definitely aggravates the problem...it is here I share your fustration because hills are my nemesis and I was just starting to really attack them!

   Rach

[RunningMum11]

Hi Rach,

Thanks so much for taking the time to reply ..... I didn't run on Saturday .. my normal run day but felt good today so have just for a short night run/walk as per C25K Week 4 Workout 3 (about 3.3km including 5 min warm up walk and 5 min cool down)and feel okay - definitely better than the last time I posted.

However I will take your advice and book in with my podiatrist .. although I don't think she is a runner, whereas my osteopath is a runner ... hmmmm... anyone know a good pod for runners in the Dandenongs...

okay have now tried the find a physio site - thanks for the tip there. and there is one fairly local to me .. but how do I know if they are good in not ...

I will also follow up the advice on another thread I have on this... was getting a bit desparate so started up a thread and then when I heard nothing came across this and tacked onto your revamp of the thread... ..

I too have a heap of goals for 2012 .. so will endeavour to get this sorted as soon as possible..thanks again.. hope you get some good news with your results Rach

Cheers