- Don’t ignore foot pain, it isn’t normal. If pain persists, see a physician.
- Inspect your feet regularly. Note changes in color and temperature, thickness or discoloration of nails, and cracks or cuts in the skin. Peeling or scaling on the soles could indicate athlete’s foot. Any growth on the foot is not considered normal.
- Wash your feet regularly, especially between the toes. Be sure to dry them completely.
- Trim toenails straight across, but not too short. Be careful not to cut nails in corners or on the sides; it can lead to ingrown toenails. People with diabetes, poor circulation, or heart problems are more prone to infection and should not treat their own feet.
- Make sure that your shoes fit properly. Replace worn-out shoes as soon as possible, and try on new shoes later in the day when feet tend to be at their largest.
- Select and wear the right shoe for your activity, in other words, running shoes for running.
- Don’t wear the same pair of shoes every day, but rather alternate them.
- Avoid walking barefoot. Your feet are more prone to injury and infection when walking barefoot. When at the beach or wearing sandals, remember to use sunscreen on your feet as well as the rest of your body.
- Use home remedies cautiously. Self-treatment often turns a minor injury into a major foot problem. If you have diabetes, it is essential that you see a podiatric physician at least once a year for a thorough check-up.
If you sometimes feel that you are “walking on a marble,” and you have persistent pain in the ball of your foot, you may have a condition called Morton’s neuroma. A neuroma is a benign tumor of a nerve.
Morton’s neuroma is not actually a tumor, but a thickening of the tissue that surrounds the digital nerve leading to the toes.
Morton’s neuroma occurs as the nerve passes under the ligament connecting the toe bones (metatarsals) in the forefoot.
Morton’s neuroma most frequently develops between the third and fourth toes, usually in response to irritation, trauma or excessive pressure.
The incidence of Morton’s neuroma is 8 to 10 times greater in women than in men.
- Normally, there are no outward signs, such as a lump, because this is not really a tumor.
- Burning pain in the ball of the foot that may radiate into the toes. The pain generally intensifies with activity or wearing shoes. Night pain is rare.
- There may also be numbness in the toes, or an unpleasant feeling in the toes.
- Runners may feel pain as they push off from the starting block. High-heeled shoes, which put the foot in a similar position to the push-off, can also aggravate the condition. Tight, narrow shoes also aggravate this condition by compressing the toe bones and pinching the nerve.
During the examination, your physician will feel for a palpable mass or a “click” between the bones. He or she will put pressure on the spaces between the toe bones to try to replicate the pain and look for calluses or evidence of stress fractures in the bones that might be the cause of the pain. Range of motion tests will rule out arthritis or joint inflammations. X-rays may be required to rule out a stress fracture or arthritis of the joints that join the toes to the foot.
Initial therapies are nonsurgical and relatively simple. They can involve one or more of the following treatments:
- Changes in footwear. Avoid high heels or tight shoes, and wear wider shoes with lower heels and a soft sole. This enables the bones to spread out and may reduce pressure on the nerve, giving it time to heal.
- Orthoses. Custom shoe inserts and pads also help relieve irritation by lifting and separating the bones, reducing the pressure on the nerve.
- Injection. One or more injections of a corticosteroid medication can reduce the swelling and inflammation of the nerve, bringing some relief.
Several studies have shown that a combination of roomier, more comfortable shoes, nonsteroidal anti-inflammatory medication, custom foot orthoses and cortisone injections provide relief in over 80 percent of people with Morton’s Neuroma. If conservative treatment does not relieve your symptoms, your orthopaedic surgeon may discuss surgical treatment options with you. Surgery can resect a small portion of the nerve or release the tissue around the nerve, and generally involves a short recovery period.