Forefoot Pain? You May Have A Neuroma

Do you have forefoot pain? Does the area right under your toes—especially the big toe–get sore after running? If it does, you already know this is not very pleasant.

If this sounds like something what happens to you, chances are you may have something called a neuroma. Don’t despair. It’s common, it’s rarely debilitating but it must be properly treated or it can worsen into a much more serious injury.

A neuroma is an inflamed nerve that is often described as a pinched nerve between the toes. Often called a Morton’s Neuroma, it normally occurs at the base of the third and fourth toes but it can also flame up between the base of the big toe and second toe.

The main nerve of your foot thickens and enlarges as the result of compression and irritation. The compression forces the nerve to swell which results in numbness or pain under the ball of the foot.

In the initial stages of a neuroma, runners tend to think there’s a lump in their socks or they feel like something’s wrong on the inside of their shoes such as a crease or a small pebble in their socks. Sometimes it feels as if you’re running on a lamp cord or there’s a lump under the foot.

At first, it doesn’t feel like much more than a minor irritant. Massaging the bottom of the foot helps and so does post-run ice, but the uncomfortable feeling under the toes never seems to go completely away. It feels like whenever you go barefoot, wear sandals or flip flops, or wear narrow running shoes it flares up and the soreness gets worse.

Once again, with so many foot problems, women runners have the highest incidence of neuromas. The reason reverts back to the shoes women often wear: narrow, tight dress shoes or even worse, high heels. Also, women who are on their feet all day on hard floors—teachers, waitresses or nurses—are especially susceptible to neuromas whether they run or not.

But anyone can get a neuroma and the primary offender is a narrow shoe which causes the toes to get squished. When the toes get crammed together in a shoe and are subjected to repeated pounding, the nerves of the foot get compressed and irritated. If you ignore this soreness long enough and try to run through it, the neuroma enlarges and thickens and what was a temporary problem could become chronic.

In some cases, surgery may be necessary to remove the neuroma. But such an operation requires a lengthy recovery period.

Fortunately, most neuromas can be successfully treated several ways to reduce the pain and soreness. Unfortunately, many neuromas never go away. The soreness lingers, but often at a tolerable level which doesn’t interfere with normal running or walking.

If you have a Morton’s neuroma which is causing foot irritation, try one or several of these methods to reduce the soreness:

1. Rest. If every step causes pain or numbness, stop running. Spending less time on your feet, will help decrease the foot inflammation. Try swimming or deep-water running instead.

2. Avoid dress shoes with high heels. Any shoe with heels higher than an inch—cowboy boots or high heels are leading culprits—should be avoided because those types of shoes will place more pressure on the ball of the foot, creating more pain.

3. Wear shoes with a wide toe box. Whenever, your toes are cramped together, this will put more pressure on the neuroma. Look for running shoes that have enough forefoot room so your toes can wiggle freely. Several running shoe brands, such as Asics, Brooks, Mizuno and Nike, offer some models in wider widths. Most New Balance running and shoes are offered in several width options and Saucony shoes have wider than normal toe boxes.

4. Ice. Using ice several times a day on your neuroma, will reduce the pain and inflammation. Try placing your foot on a bag of frozen peas for relief.

5. Use a neuroma pad in your shoe. Commonly found at pharmacies, a neuroma pad is placed in the shoe under the ball of the foot—and just behind it. The pad lifts up the bones in your foot to decrease the pressure on the offending nerve.

6. NSAIDs (nosteroid anti-inflammatories) will help. Take Aleve, Advil or some ibuprofen to reduce the inflammation.

If nothing seems to help, some podiatrists will prescribe an injection of cortisone into the neuroma for relief. Such an injection is quite painful and may only provide temporary relief, but doing so may break up the inflammation. Some podiatrists prefer not to use cortisone in this area of the foot because it may cause the fat pad to atrophy.