Searching the web for information about Morton’s Neuroma will gain you a fair share of marginal advice. While it is recognized that the nerve is damaged from entrapment and excessive pressure, the standard treatment options are so established that few care to dig deeper into the real cause of why this happens.
Morton’s Neuroma is often treated with a steroid injection on the first visit which sometimes helps, at least temporarily, but is often followed by surgery or some form of ablation, but that’s not the end of the story. Nerves are not like plumbing, “cut the pipe and cap the ends” and that’s that. Most nerves try to regenerate and repair themselves and even reconnect if cut, so you can get neuroma pain again. The only difference is that now they call it a "Stump Neuroma". Wouldn’t it be worth your while to dig a little deeper before you are led down the path of interventional procedures and possibly a lifetime of misery?
From the illustration you can see you have nerves between every toe, so why is the nerve between the third and fourth so susceptible to entrapment? It is interesting to read in some orthopedic manuals that while here is no doubt the pain is due to entrapment, the cause of the nerve entrapment is poorly understood.
When disease is studied, you can usually find rates of prevalence between sexes, age groups, behavioral characteristics etc. Women seem to be subject to more incidents of Morton's Neuroma. Why don't they ask more questions? Is it the bones of the feet? Do they have a peculiar way of standing or walking? Shoes are often taking the blame. Do they wear the same type of shoes? Do they have anything in common? Turns out they do.
After over 20 years of helping people suffering with chronic pain, we have come to the conclusion that Morton’s Neuroma is as predictable as the moon. On a clear night, it shows up as expected. Same with the neuroma. Under certain conditions, it manifests as predicted. My first question to you: Did your podiatrist give you a thorough examination including your foot mechanics? If not, you are probably subject to a standardized approach which may not be very successful while causing you more agony and pain, not to mention wasted time and money.
If you suffer from Morton’s Neuroma, chances are you favor the outside of your feet when you stand and walk. When someone calls us for help with neuroma pain between the third and fourth toes we immediately ask: How are your calf muscles? Are they tight – do you get night cramps? Virtually 100% of the time the caller affirm but not everyone experiences cramps. We ask them to look at the bottom of their shoes to see if the wear pattern shows greater wear from the middle to the little toe side in the forefoot. It always does. At that point we are fairly certain we know the cause, so we explore other symptoms that frequently go along with lateral weight bearing and they are usually confirmed.
The cause of neuroma pain between the third and fourth metatarsals is that the nerve is entrapped by excessive plantar pressure as well as more vigorous bending of the toes when pushing off with the lesser metatarsals instead of the first and second which would be considered ideal. The “Neuroma nerve” is being squeezed and pulled around the deep metatarsal ligament in a space that is already tight. The ingenious mechanisms of the body are geared to self-defense and work most of the time, but in this case, added protective tissue around the nerve makes an already tight space tighter so the Morton’s neuroma pain just gets worse.
Change the Mechanics
If you're thinking "why not just take the pressure off", you're onto a good idea. Why not try that first?
First, drugs and surgery are very lucrative businesses, and so is custom orthotics.
Second, “If you can’t trust your doctor to help you with pain, then who can you trust?" We are conditioned to trust their judgement and recommendations. Unfortunately, too many of our customers have reached the conclusion that they can't just take a medical recommendation at face value without backing it up with their own research. That's extra important if the procedure involves needles, scalpels, or radiation.
It's hard to believe, but you are reading this blog post and you're learning that we can generally take care of your neuroma pain for under seventy-five bucks and you don’t have to waste time in a waiting room or suffer additional pain. Sure, your skepticism is palpable, but if you follow through on your logic, changing your foot mechanics should at least theoretically alleviate the pain.
- Shift the pressure away from the lesser metatarsals
- Make the first and second metatarsals support your push off so the 3rd, 4th and 5th toes do not need to bend as much.
The $75 Solution
The ProKinetics Insoles do one thing only. They activate the muscles that put the first metatarsal and big toe to work. When the first and second metatarsals pick up proper weight bearing, the weight is better distributed across your feet. Pushing off with a neutral foot instead of slightly supinated beds your little toes less. Between less pressure and less motion, your "neuroma nerve" gets a break and starts healing.
What to expect
People who have just started feeling the pain, may get instant relief while those who have suffered for months and sometimes years usually have to be patient, but even they will feel a step in the right direction. As soon as you stop the repeated injury that takes place with every step, thousands of times each day, the swelling around the nerve decreases and as the local environment normalizes, your neuroma pain will be just a bad memory!
The ProKinetics insoles correct a structural deficit, the elevated first metatarsal, so unless you wear them at least 70% of the time, your neuroma symptoms may return as your foot mechanics take a step backwards. We’ve had plenty of customers over the years who felt so great they thought they were permanently “cured”. Unfortunately, that isn’t so.
Although it seems to occur at a far lower frequency, neuroma pain can strike between other toes as well. The reason is the same, focal pressure under the foot from faulty foot mechanics. Neuroma pain in the region between the 2nd and 3rd metatarsals are sometimes misdiagnosed Metatarsalgia (excessive pressure under the 2nd and/or 3rd metatarsal heads) which is also a foot mechanics issue. Try the conservative solution first. If we don't measure up and you don't experience relief within the first 90 days, send them back for a full refund. Right – What’ve you got to loose….
The discovery and caring for this neuralgia pain has seen many iterations since Dr. Morton in the late 1800s removed part of the first metatarsal bone to alleviate the pain. Click on the image to access his first case studies published in 1876.
Gloves Off Series – We’ve had it with Podiatry dogma
After 20 years of working with people in pain and with responsible and caring professionals who care for people experiencing chronic musculoskeletal pain, we have had it with conventional thinking when it comes to your feet and your structural body. We may be risking the wrath of both the podiatry and footwear industries, but so be it. There simply is no rational reason for millions of people worldwide to suffer from chronic musculoskeletal pain. In this series we will cover better alternatives (not only shoes and insoles) to many ailments originating with malfunctioning of the feet. If you are interested in learning more from a clinically experienced engineer’s perspective on chronic pain in your feet and body, sign up for the blog at mortonsfoot.com and stay tuned.
About the Author:
Bjorn Svae is the owner of GRD BioTech, Inc. dba Posture Dynamics founded in 1998. Bjorn holds degrees in electrical engineering and business and has enjoyed a career in design, marketing and sales of diagnostic medical equipment as well as business consulting and entrepreneurship. In 1997, nine years after having undergone bilateral fractured meniscus knee surgery, he met Dr Rothbart and was fitted with an early edition of the forerunner to the ProKinetics Insoles. The pain which had reappeared in the left knee immediately went away and has never come back.