Posts for tag: Neuroma Charleston
What is "Morton's neuroma" and what is the best way to treat it?
As a runner myself I have suffered from a Morton's neuroma. I have been able to manage my neuroma with basic conservative treatment and continue to run without pain. The key is an accurate diagnosis and prompt treatment. I would like to discuss the etiology of neuromas and the conservative treatment that we find helps to get our runners back on stride.
Most patient's will say that they feel a pain in between the third and fourth toes while wearing shoes. Most symptoms feel like a burning and numbness feeling shooting into the toes. Pain is typically with closed toe narrow toe box shoes and patients typically feel relief by taking off their shoes and rubbing their feet.
These are common symptoms of a condition called Morton's neuroma. A neuroma is a thickening of a nerve, and on the foot this occurs most frequently between the third and fourth metatarsal bones and toes. The nerve coursing between these areas can become inflamed when the metatarsal bones are compressed together such as may occur with tight fitting shoes. It may also be aggravated by overuse micro trauma that occurs in weight-bearing sports and exercise, and by biomechanical asymmetries such as over-pronation of the feet.
The symptoms of a neuroma can include pain on the ball of the foot that may be accompanied by a feeling of "pins and needles" or numbness to the 2nd, 3rd or 4th toes. You can also experience the sensation that your socks are bunching up under your feet.
The initial treatment for a neuroma involves the correction of the causative factors. This can include replacing worn out shoes or purchasing a shoe with a wider toebox to allow more space for the front part of the foot. This applies to your dress or business shoes as well as your athletic shoes. Another form of self treatment involves placing a spacer such as a cotton ball between the affected toes to remove pressure of the nerves. If this is still not effective your podiatrist may recommend a series of injection (NO MORE THAN 3) to help reduce inflammation around the nerve. Other conservative treatment may include the use of metatarsal pads or orthotic devices to control any biomechanical problems such as overpronation. Up to three cortisone injections per year can help to resolve symptoms. Another type of injection is alcohol sclerosing agent that essentially quiet's down the nerve inflammation without the need to surgically excise. Very rarely do we need to surgically excise neuromas from our experience over the years.
Finally, if aggressive conservative treatment does not resolve your symptoms, and the pain is causing a modification of your normal activities, surgery may be recommended to remove the inflamed nerve.
As with any other injury, a careful diagnosis is necessary because other problems such as metatarsal stress fractures and metatarsal bursitis can sometimes mimic the symptoms of Morton's neuroma.
Our practice has both diagnostic ultrasound as well as digital x-rays to help make the most accurate diagnosis.
For more information on neuromas please refer to our video on neuroma treatment.
We have less than two months before the Cooper River Bridge Run 2015. We would like to briefly talk about a common running injury that we see which are "Neuromas." Typically Neuromas develop from a reduction of the fat pad on the bottom of the foot combined with repetitive stress such as running that can causes an inflammation of the digital nerve. The common complaint is pain in the ball of the foot in between the 3rd and 4th toes or 2nd and 3rd toes. Pain can be described as burning, tingling, numbness, and sharp. It usually feels like a sock is bunched up in your shoe.
The way we diagnose neuromas is usually clinically and the faster this condition is diagnosed the quicker the recovery is. We have digital x-ray and diagnostic ultrasound in the office to help rule out other common conditions. I have experienced having a neuroma over the years from running and have followed a simple conservative treatment plan that I outline for my patients to keep them active. Conservative treatments include: metatarsal pads to offload and take pressure off the neuroma, cortisone injections, custom offloading sports orthotics, shoe modifications, NSAIDS, alcohol sclerosing agent injections for chronic cases.
Included in this blog is a brief video on Neuroma diagnosis and treatments. It provides nice tips on how to prevent and treat neuromas.
If you are feeling numbness, tingling, burning, and radiating pain into the toes you may have a neuroma. We can evaluate and treat this common running injury and help to alleviate your symptoms so you can train and run in the upcoming bridge run. Very rarely is surgery indicated and the conservative plan that we use keeps you running along with helping to resolve this common foot ailment.
A common foot ailment that we see in our practice is ball of the foot pain. Neuromas, reduction of fat pad, bursitis, plantar fasciitis, Sesamoiditis, and Capsulitis are the more common reasons for ball of the foot pain. We would like to educate you on a very common but not much talked about foot condition which is Capsulitis. Capsulitis is an inflammation of the joint capsule than connects the metatarsal bone to the toe bone. This thick fibrous tissue is a very important structure and when not treated early and correctly can develop into a tear of the capsule and progressive hammer toe deformity. We see many patients that come to our offices that presents with pain below the 2nd MPJ joint which is the more common area to develop capsulitis. Please take a look at one of the leaders of our profession Dr. Weil who discusses in the article below what Capsulitis is and treatments avaiable. I have included a link to our Neuroma video as well as the state of the art surgical treatment of plantar plate tears that Dr. Weil developed.
Again the key is accurate diagnosis and this condition is often time treated as a neuroma. Conservative tx for capsulitis typically resolves the condition.
If surgery is needed Dr. Brown and Dr. Saffer have been trained in this latest surgical technique for plantar plate tears. We have also provided a surgical video from Arthrex website that discusses the surgical treatment of plantar plate tears.