Ah Neuroma…

It sounds like you've hit all the right concepts, but to reiterate:

First make sure your shoes are Wide enough. You should see NO outward flex on the sides when you weight the foot. You need to give you foot the space to spread out.

Then consider an generic or custom orthodic that has a 'metatarsal button' located below your 3/4. Don't go by shoe size, size to locate the button properly, and then cut to fit.

If your arches are collapsing then the orthodic should address that as well, which will reduce the amount of forefoot spread.

Comments?

I have no experience with Morton's Neuroma but I read this trail journal and one of the authors had it.

http://www.trailjournals.com/entry.cfm?trailname=4084

She had to get surgery before her hike and talks about it a fair amount.

Pat,

I'm pretty sure you'll find that support will work better for you than width. A Morton's neuroma is generally caused by a collapse of the transverse arch, ie the arch that runs ACROSS the foot, under the ball of the foot. As this arch collapses it compresses the nerve which runs between the bones that form this arch.

As Greg says a metatarsal dome will reform this arch, but I find that a normal fitting shoe for your foot shape helps to buttress the ends of this arch. It's also common for the longitudinal arch to collapse at the same time, so a pair of orthotic inserts may be appropriate. There are a number of studies published which assert that off the shelf orthotics are just as beneficial as custom made. The trick will be to find one that places the met dome AND the long arch correctly.

You may be better to find arch supports and add your own met domes. I generally do this by taping the dome correctly positioned under the foot, and then standing on the arch support and marking it. Even better if you can do this in the shoe, but you need to use a few tricks to mark it.

The other thing to think is acute and long term. Initially you need to settle the inflammation. The met domes will assist this, but you also need to use a soft sole any time you aren't using them eg around the house. I find Crocs are pretty good for this.

Rod

Pat,
I just had a similar flareup under the 2nd metatarsal head and the "metatarsal button or dome" has been just the ticket for me. Since I already have orthotics, it was a simple matter to take them in to my podiatrist and have the domes inserted. I didn't miss a beat, hiking wise, which is pretty amazing, because the darn thing was really sore. The pain receded rapidly once that head was lifted a bit. I'd recommend seeing a sports podiatrist rather than trying the do-it-yourself approach. There may be more than one factor involved and you might not figure them all out and end up worsening the condition while you're tinkering around. My .02 worth.

I've had Morton's neuroma for most of my life.

My doctor suggested I buy metatarsal pads made by Spenco. I did that and also bought lots of other brands of pads. I tried all kinds of shapes and sizes. I tried putting them in my shoe on top of the insole and underneath. Basically the pad forms a bump that relieves the pressure on the nerve which will allow it to heal.

I found the pads uncomfortable, but I used them for years off and on. I would take them out when the discomfort got bad.

The best thing I've done is buy wide shoes. If I have to buy shoes with two or more inches of extra room after my big toe, so be it. If the guy at the shoe store looks at me funny, I don't care.

I worried about the neuroma as I planned my PCT hike last year. I put the metatarsal pads in with my gear. After they bugged me I took them out. Eventually I ended up not even using them.

After 1500 miles of walking on the PCT, I have not felt any of the pain or the "clicking" or numbness since. I think all that walking in clown shoes actually did the trick.

Thank you for posting this!

I was cross country skiing just over a week ago and got a pain in my left foot. I wondered if it was from wearing boots that were too narrow (I have wide feet).

I've had the pain happen 2 times in the past (once from dunking a basket ball and landing hard in sandals – DUH!, and the other also from skiiing in the same boots). The primary symptom other than pain is a popping feeling between the two middle of the 4 smaller tows on my left foot.

I was wondering what this was, but being male I just assumed it would go away (hey, there was no blood right?). I hadn't put much thought into it pas that. Now I'm reading all about it, and I'm realizing I shouldn't be ignoring this.

I obviously should go to a pediatrist to get a real diagnosis, but I can pretty much guarantee it's the problem.

I have had Mortons Neuroma in both feet for about 6 years. I've tried all the stuff mentioned here but nothing stopped the intense pain. I've had two rounds of shots of a solution intended to deaden the nerves. This has worked fairly well for me. I still have pain but it is manageable. Surgery is the other option for serious cases that don't respond to the mechanical changes mentioned in other posts. There are two types as I understand it, one cuts the nerve(s) the other cuts the tendon to allow the bones to separate.

In any case I recommend stopping and removing your shoes as often as possible during your hikes. In most cases this provides some relief.

I appreciate hearing your experiences on this and will continue working through them in order of least trauma.

It surprising how much the pain varies from day to day, even hour to hour. S'pose that's a cup half full/empty thing…