Morton's neuroma

[merrydog]

I have suffered and coped with a neuroma for the last couple of years. I'm pretty sure it started with ski boots that were too narrow in the forefoot. By the time I had the boots blown out to accommodate the width, I had caused a permanent problem.

It's great to read that the traditional treatments most DPM's use for neuromas (orthotics, injections, etc.) actually worked for some divas. Orthotics actually made my pain worse and I was very leery of killing a nerve with injections to address the pain. I was able to find a podiatrist with a more conservative approach who diagnose the underlying mechanical issue and provide a course of treatment that helped me. You may find this Chiropractor's post on the causes and stretches for a neuroma to be interesting.

 

[SkiNana]

The location of your pain, mustski - the interspace between the 3rd and 4th toes - is certainly classic for Morton's. The traditional evocative test is to give the forefoot a firm squeeze (as if in an overly narrow shoe). This should reproduce the pain in that area. If it does not, most podiatrists, in my experience, show you the door. Mine is also aggravated by pressure over the nerve running up the top of my foot to the ankle, and massaging there both helps and hurts (like poking an aching toothe) so you might consider the pressure there.

Orthotics (custom footbeds) and having your boot shells "popped" to provide more lateral space are immediate steps you can take. Don't go to an "adequate" podiatrist! It's worth hunting, and traveling, to find an expert in the field! Morton's neuromas are miserable, rotten little devils that can have you sitting in the snow on the top of Killington Peak, boot off and rubbing your screaming foot! Ask me how I know that! Surgery may have improved, but it certainly wasn't a cure-all back in the (gulp) '70's! I've had better luck - recently - with ablative therapy done with repeated injections of alcohol. None of it's fun. Good luck!

 

[bounceswoosh]

It's definitely not something to mess around with. I had to have my nerve removed, and I still have problems in some situations. (Ski boots are much better, but my climbing shoes are now a problem, where they were perfectly comfortable before the surgery.) Find a highly-recommended podiatrist and get that stuff sorted - the sooner, the better.

 

[volklgirl]

Rolling/clicking, tingling and numbness, exploding pain......sounds like the early stages of neuroma to me.

Anything that compresses the ball of your foot (sideways or top-to-bottom) can irritated it. Get it treated NOW as it really will only get worse.

On a side note (another update)....I'm just now developing more problems with the same foot. I don't know if the original neuroma that we tried killing with the alcohol and cortisone is now irritated or if I've developed a stump neuroma post surgery, but OWWWW! My cross country boots especially, since the boot is narrow AND I'm balanced over a tiny piece of plastic for hours, is the worst, but my snow/snowshoeing boots and my ski boots are starting to hurt again. Even running on the treadmill is shooting little bursts of white-hot pain into my foot. DRAT!!! https://www.podiatryinstitute.com/pdfs/Update_1989/1989_36.pdf Totally sounds like me. Grrrrr

 

[mustski]

My ski boot has plenty of room in the toe box. I switched to a lighter sock and micro adjusted the ankle buckle on my boot. It helped. I had an awareness of the area when I removed the ski boot but not the pain. I don't want to do anything before Diva West because right now I can still ski. After that, I'll go see my bootfitter and see if he can do something with my footbed. I'll see the doctor after ski season. In the meantime, I'll be sure to avoid compressing the toe area.

 

[patoswiss]

Subscribing to the post. My mom, aunt, and grandmother all have had surgery on their feet (both feet) for neuromas and I am probably next. Mom says my numb toes are the start of it, although since I started wearing Sanita/Dansko clogs a few years ago the numbness has almost disappeared. This post is reminding me to be thankful for the little extra volume in the forefoot of my new ski boots!!!

 

[bounceswoosh]

I had surgery on my left foot a few years ago. In an hour, I see my podiatrist because I'm having issues again. Especially disconcerting is an itchy spot that can linger for hours - right where the stump of the neuroma is. Sigh.

 

[mustski]

I am making an appointment with my boot fitter today. The neuroma is part of the problem, but I noticed other issues at diva west. The problem with our conditions is that those are the first full ski days I've had since I bought the boots last March! Eeek!

 

[volklgirl]

Have now had 2 rounds of cortisone into the original neuroma and it's back to being a more occasional annoyance so far. I'll know for sure after this coming weekend if that's the solution as I'll be XC skiing and snowshoeing Saturday and alpine skiing Sunday. <crossing fingers and toes!>

 

[bounceswoosh]

My doctor had me try a gel metatarsal pad in my normal shoes - actually, stuck to the bottom of my foot. At first I didn't think it was doing anything; then I went without. Oh, yes, actually it was. Let's put that back in there. Gellin' like a felon, if you remember that ad.

I might succumb and get orthotics with built in metatarsal pads.

 

[MaineSkiLady]

My doctor had me try a gel metatarsal pad in my normal shoes -

C-Ped did this for me with SuperFeet last summer, but I think my issue stems from an overuse injury last summer. Wore met pads all summer and fall. Still some twinges. (However, they are "invisible" right now, given the rest of my body's current condition....all is relative?) Still -- worried about possible Morton's development.

 

[bounceswoosh]

C-Ped did this for me with SuperFeet last summer, but I think my issue stems from an overuse injury last summer. Wore met pads all summer and fall. Still some twinges. (However, they are "invisible" right now, given the rest of my body's current condition....all is relative?) Still -- worried about possible Morton's development.

*nod* I have never had met pads help me. This gel one feels great, although it is weird underfoot. I am not confident if an orthotic with a lump in it will feel as nice as the gel.

 

[mustski]

I am seeing my boot fitter on Monday so I will find out. So far mine mostly hurts when I take my ski boot off, though I did have difficulty with finding adjustments when skiing all day for multiple days at diva west.

 

[Soho]

I bit the bullet and had both neuromas removed in May at the same time. I was able to work from home so I only missed one day. It been two months now and recovery has been ok to good. My very bad left foot feels great. My not as bad right foot has more scar tissue which is giving me problems with flexibility. Dr said to give it six months. I'm hoping ski season 14/15 will be better as last winter was the worst for pain.

 

[bounceswoosh]

I bit the bullet and had both neuromas removed in May at the same time. I was able to work from home so I only missed one day. It been two months now and recovery has been ok to good. My very bad left foot feels great. My not as bad right foot has more scar tissue which is giving me problems with flexibility. Dr said to give it six months. I'm hoping ski season 14/15 will be better as last winter was the worst for pain.

Can you work with a massage therapist or PT for the scar tissue? It's amazing how much they can break down. I got my surgery several years ago, and I still periodically ask my massage therapist to do more work on my scar. There's always a little more to get at.

 

[mustski]

The neuroma bump the fitter put in my foot bed completely relieved my pain from ski boot removal. I am holding off on any surgery unless I actually have pain skiing, walking, etc. I know it's getting worse because my 2nd and 3rd toes are spreading apart quite a bit. Here's hoping it doesn't rear it's ugly head during ski season!
@Soho keep us updated. I'm very interested in how your season goes post surgery.

 

[Soho]

I am not seeing a PT at this time as I need to get all my surgery paid off first ( yes I have insurance but deductible and copay plus out of pocket needs to be paid). Had I known last year I would have done this I would have put more in our fsa account. So I have some exercises to do and hubby is also helping. It is getting better. I also have been very good about my footwear...doctor wanted me in tennis shoes for at least six weeks which I have done. My feet get hot so she said to look for sandals with arch support which I have also done.

 

[volklgirl]

The latest update for me is it's likely a stump neuroma from the original surgery. I've now had 5 cortisone shots and each works a little bit longer (the last one was awesome for more than 5 weeks), but the Dr. says no more cortisone, so we're back to trying the alcohol thing before considering surgery. He did say he does a special stump neuroma surgery that very few other surgeons will do where they cap the end of the remaining nerve once the irritation is removed. He's done 12 of them so far and has had a 100% non-return rate after doing it. Not that that makes me want to endure surgery again, especially since this one requires a bottom-of-foot approach and much longer recovery time.

The shoes that I've had met pads put in seem to irritate it the least, but wearing some of my sandals, one pair of tennies,one pair of hikers, and going barefoot is killer right now.

Sigh. So frustrated.

 

[bounceswoosh]

The latest update for me is it's likely a stump neuroma from the original surgery. I've now had 5 cortisone shots and each works a little bit longer (the last one was awesome for more than 5 weeks), but the Dr. says no more cortisone, so we're back to trying the alcohol thing before considering surgery. He did say he does a special stump neuroma surgery that very few other surgeons will do where they cap the end of the remaining nerve once the irritation is removed. He's done 12 of them so far and has had a 100% non-return rate after doing it. Not that that makes me want to endure surgery again, especially since this one requires a bottom-of-foot approach and much longer recovery time.

The shoes that I've had met pads put in seem to irritate it the least, but wearing some of my sandals, one pair of tennies,one pair of hikers, and going barefoot is killer right now.

Sigh. So frustrated.

=/

 

[mustski]

I have my annual physical next week so I'm going to ask my Dr's opinion. I think I am also going to purchase orthotics with a met pad for my shoes. I haven't needed it so far and I have no pain when walking barefoot or otherwise. I am just trying to be proactive because I don't want to miss any skiing. I am a total wuss when it comes to pain!