Dear Ask The Doctor: Hello, I am about at my wit's end after seeing 3 different doctors for some recurring foot pain. About a year ago, I stubbed the last two toes of my foot very badly against a wall. I stumbled and my bare foot stubbed against the wall. I had bad pain for about 4 days until it began to subside. It has never gone away and is recently begun to get worse. I am an extremely active person, my job requires me to be on my feet and I love sports and running, and I have kept away from running for the time being. It is localized pain located around the 4th metatarsel, near the base of the toes. It makes my last two toes feel "too close together", not numb, just a weird feeling. It doesn't necessarily hurt with each step although the effects of the pain has caused pain in my ankle, knee but when I step, I can get an extremely sharp stabbing pain at that point in my foot. Can't run or jump and will hurt while walking; also hurts when walking barefoot on a pool deck. I've gone through therapy for supposed stress fractures (ended up negative) and the MRI shows nothing so they said tendonitis. The last doctor has said it could be a supposed neuroma but that I didn't fit all the signs (didn't show up on the MRI, knowing the cause of the pain and compression of my toes did not reproduce the pain) so was hesitant to diagnose this. I am considering a call to a chiropractor. I am beyond frustrated and desperate for relief and answers so that I can get back to doing what I love. I can't not be active. Please respond if you can with any ideas or suggestions. I need any help I can get after spending a lot of money to tell me they don't know. Thank you for your time.
Dear Mary Anne: Well, Morton’s Neuroma is not a true neuroma, is a growth secondary to repetitive nerve irritation, you could try conservative treatment as follows: try to wear soft-soled shoes with a wide toe box and low heel, altering the alignment and elevation of the metatarsal heads which is achieved by wearing a plantar pad. This prevents more compression and irritation of the digital nerve. Also a physical therapy program can be beneficial and may include: local cold packs, ultrasound, deep tissue massage, and stretching exercises. In the case that all of the above do not work for you, and you have increasing pain with or without cramping, then, surgery might be considered.