Ask the c.Ped – Morton’s Neuroma

Helen Russell

Helen Russell is the owner of Metro Run and Walk with her husband Mark. She is a certified pedorthist and has completed several marathons!

Last month, I briefly discussed Morton’s neuroma.  You may recall that a  Morton’s neuroma is a nerve enlargement usually developing between the 3rd and 4th metatarsals.  Our friend, Dr. Jeffrey Graziano, sports podiatrist from Alexandria Podiatry Associates, has this to say about Morton’s neuroma:

There are have no magic bullets but a diagnostic ultrasound may to help determine the best treatment option. Based on size of the neuroma, doctors can make better decisions on what might be most effective for your particular situation. Smaller neuroma’s can respond to further cortisone injections, combined with orthotic support.  Alcohol injections may be effective in stubborn cases but it tends not to work on larger neuroma’s.  Radio frequency is a new option that is more extensive than injections but will keep you from running for 2-3 weeks, however it’s better than surgery.  If your desire is to manage it without further treatment, an orthotic with a 2-4 metatarsal pad is a reasonable option but you may be able to up the game with a custom orthotic.  Overall success for orthotic management alone is around 30%.

The arch supports combined with proper stretching, periodic NSAIDS, icing and proper shoes is what you have to work with. As with any overuse injury, watch your training, too much too soon can flare it up.

Also, in Road Runner’s Club of America Club Running, Winter 2010/2011 periodical, there was an article that discusses neuropathies (usually nerve entrapment), capsulitis (inflammation of a fluid-filled sac), and plantar fasciitis.  Its an interesting article and highlights that there is much overlap and confusion about these conditions.

Self-diagnosing may lead you down a path that delays appropriate treatment.  So, if you are experiencing chronic foot pain that you can’t get rid of, go see a podiatrist.

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