Neoroma?

Woodsman

Barefooters
Jan 13, 2012
125
96
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I am having some pain in my 4th toe. It is not constant. It happens occasionally when my foot lands there is a sudden shock like feeling that hits just that toe. It's feels similar to when you hit your funny bone. It on bothers me when I run barefoot and on rare occasions when I am barefoot on a really hard surface. It doesn't bother me at all when I have my casual Vivo's or Lem shoes on.

Can anyone tell me what's going on? I am think of switching to some kind of minimalist running shoe, though would really prefer not to.

thank you.
 
It could be a "Morton's Neuroma." Have you seen a doctor to get a diagnosis?

Despite the name, MN is not a true tumor, and Morton was not the first to classify it (a chiropodist named Durlacher was). The condition was misnamed and misclassified a long time ago, and the name stuck, although many in this medical field have fought to have the condition renamed and reclassified to interdigital perineural fibroma or peripheral nerve entrapment, etc. MN is the scarring of the nerve sheath caused by compression/entrapment.

The #1 cause of MN is the types of shoes we wear, shoes that have a narrow toebox and/or elevated heels. Narrow shoes pinch and compress the nerves between the metatarsal bones, and elevated heels force our weight to be carried over the balls of our feet leading to more compression of the nerves. This is why women are more affected by this condition than men, but men do get it too.

If we would have stayed barefoot from birth we would never experience MN. Third world countries don't have this ailment or most of the foot conditions we have in so-called "developed" countries.

Regardless, if you are in the beginnings stages of a developing MN, there's a chance you can calm it down before it becomes full blown, but it COMPLETELY depends on the choices you make from here on out.

Rest it as much as possible. Don't wear shoes unless you have to. When you do, only wear shoes with wide toeboxes and no elevation (zero drop). Consider a metatarsal lift/pad placed properly in your shoes for when you do have to wear shoes. Ice it every chance you can, if you can. (Ice always bothered mine but helped others.) Don't run AT ALL. Don't walk long distances. Avoid surfaces that bother it, barefoot or shod (soft surfaces always bothered me when barefoot, such as, carpet, sand, and grass).

If you show improvement after a few weeks (yes, weeks) of doing this then that means you may have reduced the the inflammation and calmed down the nerve (although it can reoccur again later) and that your nerve has not yet "scarred." Once the nerve scars, then you have developed a full-blown MN, and other more invasive treatments will have to be considered. We can talk about those when the time comes.

In the meantime, just know that if your doctor recommends cortisone shots, alcohol sclerosing injections, or alcohol neurolytic injections (there's a big difference between the later two) you will develop scar tissue, as any injection of any kind will cause scarring of the surrounding tissues. Scar tissue upon scar tissue will make your condition worse. We can talk about that too when the time comes if you'd like, but first please try to calm it down on your own.

Remember that when you feel that nerve firing, it means you have done something or are doing something to aggravate it, and therefore you are adding more scar tissue to it.
 
Oh, and now you know "why" the BRS was founded.

Knowing what I know now, I wouldn't have jumped to any type of treatment. I would have kept my shoes off 100% of the time. I honestly believe that I would be just fine right now if I had. Instead, I'm so much worse off.
 
Thanks TJ for the both thorough and terrifying answer.

It is something that has come and gone. It actually first started several years ago when I was wearing shoes. Normally I just felt it every now and then, but it has been more consistent lately. It will start up a mile or so.

Going without shoes and not walking is impossible though I don't need to walk too much, but I only own vivo's and Lems. I guess I'll hit the exercise bikes for a couple of weeks and see how it goes. I might try some toe spacers that can fit in my shoes. I might look for a doctor if I can fine a barefoot friendly one nearby.

I also do yoga a couple time a week, good or bad? This actually started when I slacked off for about a month.
 
It seems grimm, yes, but it isn't the end of the world. I do miss running and being fit like I was, but I have other interests that I focus on now.

Mine started sporadically, randomly when I would wear certain shoes after I had my first child. Women's feet grow due to hormone changes. I went up a size and didn't recognize it, so the shoes I wore would sometimes hurt. It set in more when I started taking step aerobics for a couple years; during some of the later classes, I could feel the pinching of my nerve (started with one on one foot, then progressed to the other later). Then when I became a more consistent runner, the running shoes would cause the same pain but more intense while running. It started somewhere around five miles, then crept down to one mile. I could stop, take my shoe(s) off, rub my toes, and the pain would disappear immediately. As time has gone on, the pain stops rubbing away so easily and lasts with me into the night, sometimes into the next morning.

If you notice any pinching or numbness while riding an exercise bike or on the elliptical, then get off of it immediately. That's a sure sign that what you're doing is making it worse.
 
Oh, another thing I did to "buy" some running time was to make a splint out of a wide, elastic band. I sewed it to fit around my 3rd and 4th toes. This gave the nerve being compressed a little more room to breathe and gave me a little longer distance to run (yes, barefoot)...for awhile there until I just couldn't crank out the miles anymore due to too much pain too soon in my runs.

I'm not saying for you to run at all at this point. It's just something to try if you can't stand the feeling of the toe spacers (like Correct Toes) in your shoes or don't want to spend the money on them (quite expensive). And this may be a better option for when you are barefoot because I could never get the Correct Toes to stay on my feet when I was barefoot.