When a neuroma is not a neuroma.
Not all bathroom tissue is Kleenex. Not all copies are Xeroxed, and not all pain in the ball of your foot is a neuroma. A neuroma is a common nerve condition that causes pain, shooting sensations, burning, tingling and numbness in the ball of your foot and into the toes. But pain on the bottom of your foot behind the second toe may be inflammation of the joint capsule, the soft tissue that holds your toe to your foot, and not necessarily a nerve problem.
If your foot is not as stable as it should be then the first metatarsal, the long bone behind your big toe, elevates up excessively. This transfers the weight-bearing forces to the second metatarsal bone and the joint capsule. With every step you take, the second toe joint is bearing an excessive amount of your weight which leads to irritation and inflammation of the joint.
Just like gout has become the layman’s diagnosis for all-things-painful-in-the-foot, “my foot hurts, I must have gout,” neuromas have earned the reputation as the go-to diagnosis for all-things-painful-in-the-ball-of-the-foot. “The ball of my foot hurts. Must be a neuroma.” It’s even a common misdiagnosis from some non-foot specialist docs. “You have pain in the ball of your foot. Must be a neuroma. Better see a foot doc.” Which is a good recommendation of course, so it can be properly diagnosed and treated correctly. Not all ball-of-the-foot-pain is treated equally.
At Kansas City Foot and Ankle, we perform a comprehensive exam including diagnostic testing such as digital x-rays and diagnostic ultrasound right in the office, as well as MRI when necessary. Treatment for capsulitis may include padding, anti-inflammatory medications, and sometimes cortisone. But the most important aspect and the long-term treatment is with custom-molded shoe inserts called orthotics. Orthotics address the cause of the problem by providing the appropriate stability to your foot, eliminating the excessive forces beneath the second toe joint.
Are your feet hurting your lifestyle? Come see Dr. Green at Kansas City Foot and Ankle so you can return to your favorite activities quickly and comfortably. Call for your appointment 816-943-1111 (often same day).