Why is it that women, in the face of all good sense and reason, insist on jamming their feet into shoes that don’t fit for the sake of fashion? The savage effects of high fashion on women’s feet are endless. But wait guys, don’t stop reading just yet! Heels are not the only co-founder of foot problems. Flat shoes have a stake in it too! Flat shoes promote excessive pronation (occurs when the arch falls flat). Being at either ends of the spectrum fashion-wise, these varying shoe styles come together on one commonality: both can cause neuromas.
Neuromas are quite scary sounding but the truth is they are benign. If a neuroma wasn’t as exquisitely painful as it is, you would hardly even notice it. The two scenarios above both paint a picture of a foot moving in ways that causes abnormal forces and shearing. The metatarsal bones in the mid-foot, should line up straight with the toes. However, when in a compromised position, such as wearing a high heel or in unsupportive flat shoe that leads to flat foot, the metatarsal bones tend to rub on the structures that lay between them. And what are these structures you may be asking? Nerves for one! When a nerve is rubbed repeatedly by the bones, the nerve is irritated and pushes back by swelling up. This is what causes the pain. A normal nerve is like a skinny piece of string. And a neuroma along the nerve looks like a knot tied along the path of the string. And boy does it hurt! If it becomes very large you may notice your toes splay in opposite directions due to the bulging nerve pushing them apart. Neuromas are common between the third and fourth toe and in this space are termed Morton’s neuromas, but they could potentially occur between any of the toes.
Wearing supportive shoes that promote healthy foot function is the key to preventing neuromas. I know- sneakers are not the most fashionable walking modality. But you don’t have to limit yourself to sneakers to get the support you need. Custom-molded orthotics help stabilize your foot and decrease your potential from forming a neuroma! Orthotics will hold your feet in a functionally optimal position as you walk. Without proper support, neuromas that develop can cause shooting pain on the bottom of your foot and feels like a wadded up sock. Very uncomfortable! If you are currently suffering from a neuroma, a pad underneath the neuroma can be very beneficial to relieving pain and can be easily incorporated into a pair of orthotics or your shoes. There are other avenues for more severe cases of neuromas.
For patients in intense pain, a corticosteroid shot is available for short-term pain relief. This therapy, however, cannot be used long-term as it is has a multitude of side effects (like muscle or fat atrophy). Instead I recommend cryoanalgesia. In short, cryoanalgesia uses extremely cold temperatures internally to block the nerve from shooting out pain signals. For a more information, check out my cryoanalgesia webpage and video which describes the in-office procedure in more detail. Surgical removal of the neuroma may be necessary on cases where more conservative treatments aren’t enough to keep you comfortable.
Be good to your feet. We often don’t realize how important our feet are until they hurt during normal activities like getting from point A to point B. Remember, that while high heel shoes are obviously less stable than running shoes, flat shoes can be equally as destructive. Kansas City Foot and Ankle has many ways to help you recover from your neuroma. Call today for an appointment and let’s get rid of that neuroma that is causing you so much pain.