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McPick
03-09-2006, 11:45
Morton’s Neuroma is a painful condition in the ball, and usually 4th toe, of the foot. It is caused when a certain nerve between the 3rd and 4th toes is compressed between the bones. There are many web site that describe this condition in detail, including: http://www.podiatrychannel.com/mortonneuroma/ (http://www.podiatrychannel.com/mortonneuroma/).

Those who live with (suffer) Morton’s Neuroma know that the slightest change in footwear, or even a normal twist of the foot while walking or jogging, can cause this nerve to send an immediate, sharp and painful reminder of its presence. (Sometimes I can almost hear a ‘click'…)

I first became aware of this condition when I was a little kid, wearing those very unforgiving leather ski boots. (Thank goodness for the ‘flow’ products.) The balls of my feet were compressed, the nerves would be pinched and my 4th toes were often numb. (Yes, both feet.) I’ve learned over the years to shop for wider shoes and to break them in slowly, to minimize (never eliminate) this painful occurrence.

Here’s an example of how even the slightest change can affect this nerve. While hiking recently, I wore a VERY thin pair of silk socks under my regular smart-wool-type hiking socks. After only a few yards I felt the long-known warning signs from my neuromas. It was just that quick. I immediately stopped and took off the silk socks and put my hiking socks and shoes back on. The pain was gone. I’ve been amazed over the years, at how a seemingly insignificant change inside my shoes can matter, one way or the other, to these nerves.

Although I’ve never tried a custom-fitted orthotic device, I have placed numerous items between my 3rd and 4th toes, to keep them spread apart. (This really helps.) Interestingly, the item that has worked the best for me is a small, carefully folded piece of paper towel. (No joke.) I’ve learned to tie my shoes or boots carefully, leaving plenty of room in the toe box so as not to compress the balls of my feet.

I’ve also learned that leaving the toe box of the shoe too loose can have the same, painful affect on these nerves. I think the pain occurs in this instance because the front parts of my feet have too much room to move.

I’d like to try some of the inserts, as described in MisterSweetie’s “Good Insoles” thread below: http://www.whiteblaze.net/forum/showthread.php?t=13405 (http://www.whiteblaze.net/forum/showthread.php?t=13405) However, I must admit that just the THOUGHT of adding something more to an already crowded space in my shoes causes my dang Morton’s Neuromas to fairly tingle with anticipation. (They are always lurking… Always!)

I don’t fear them for my upcoming AT thru hike. But I know I’ve got to be as aware of them as I am of every other piece of gear in my pack.

Anybody have any thoughts on this subject? If you are affected by this condition, what’s helped (or hasn’t helped) you?

vipahman
03-09-2006, 12:02
Never heard of it before, but it sounds like carpal tunnel of the foot. Thanks for the info.

Bblue
03-09-2006, 13:18
My hiking partner had this condition. She put up with it for a long time before seeking medical treatment. Our foot doctor (I've had other foot problems) treated it this way. First an injection of some steroid anti inflamatory. Didn't help. Then surgery to remove the swollen nerve. This totally fixed the problem. About 6-8 weeks healing time, if I remember correctly. She has no problems now although she is darn picky about her shoes and boots.

AbeHikes
03-09-2006, 13:31
Received a medical discharge from the USMC because of mine. Had it cut out in '94 or '95. I don't even worry about shoe width anymore. Works good for some people. It doesn't for others. Just make sure you get a good podiatrist. If you're in NW Georgia, this is the man.

Spencer C. Misner; DPM (http://www.footweb.net/c/hi.cgi?cs=us-ga-dalton&x=2013&pro=Podiatrist&l=0)
1432 Broadrick Dr.
Dalton, GA

peter_pan
03-09-2006, 14:49
Steriod shots work for me...I get peace of mind just understanding it...and knowing how to adjust for it...for me the first sign was the feeling of bunched sock under the toes that was fine when I checked...mentioned it to the doc at an annual physical and she sent me to a podiatrist...glad that I had a check up before my two month section in 2003.

Pan

Mother's Finest
03-09-2006, 16:00
McPick,
I responded to Mr. Sweeties thread before. Sounds like you have things pretty dialed in with your foot. That said, Morton's Neuroma can be an extremely painful and difficult condition to fix.
You are doing almost everything correctly with your shoe gear choices. The book on Morton's Neuroma is to avoid shoes that squeeze those toes together (to avoid aggravating that nerve). You should also avoid any type of heel (this is usually much more of a problem for ladies, though I do not know how many cowboys are out there reading this, meaning cowboy boot wearers) as a heel will lever the foot up and put more pressure on the forefoot.
Other than that, the only non-surgical option you have is proper metatarsal support. Usually this will be built into a custom orthotic, to make sure that it is in the proper place. Metatarsal support will look like a bump, and it should hit just proximal to the ball of your foot. Meaning that it should be just behind it. This will lift and spread your toes, taking pressure off the nerve with every step. Now, this does not always work, and if your feet are very rigid, may not work at all.
Finally, surgery is your last option. As some have stated on this board, it can be very effective. Before I had surgery, I would find a good Certified Pedorthist in your local area and let them attempt to craft you a quality orthotic.
any questions, please pm me.
Mother's Finest, C.Ped