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Neuroma Pain

Neuroma Pain

sciatic nerve
The nerve becomes trapped between ligaments and bone.

A Neuroma is essentially a pinched nerve that can occur anywhere in the body where a nerve can become compressed. Most often however, neuromas are associated with foot pain, particularly pain between the third and fourth toes. It may start with a tingling or burning (hot) sensation, but if allowed to progress, you will develop significant chronic pain between the toes that may radiate into the ball of the foot and cause numbness in the third and fourth toes which makes standing and walking difficult and painful.

The nerves between your toes are the furthest branch of the sciatic nerve that controls most of the muscles in your leg and foot. These branches extend between all your toes. They are routed through a narrow channel surrounded by ligaments above and below and the metatarsal bones on each side.

Conditions making Neuroma pain worse

When a nerve is exposed to continuous pressure, like most of your body, the nerve will try to protect itself. Just like you may have callused skin under your feet, or on your hands from gripping tools, the nerve generates protective tissue to shield itself. Often referred to as scar tissue, this thickens the nerve and it does not take a rocket scientist to conclude that this will only make the situation worse when limited space is the origin of the problem.

The nerve between the 3rd and 4th metatarsal heads is particularly sensitive because of the narrow passage and because many people have a propensity to shift weight bearing to the outside of their feet to compensate for over-pronation. This nerve may also be subject to rubbing as the medial and lateral columns of the foot have different characteristics. The medial column consists of the first three metatarsals which is attached to the midfoot differently than the lateral column made up by the 4th and 5th metatarsals. Generally, the medial column is more flexible while the lateral column is stiffer.

Morton’s Neuroma

Why is nerve pain between the 3rd and 4th metatarsals referred to as Morton’s Neuroma? Dr. Dudley Morton was the first doctor to identify the cause of this pain syndrome. In studying the feet and the mechanics of the feet, he identified the foot structure that is most likely to cause significant over-pronation. See Morton’s Foot Syndrome.

Over-pronation causes the arch to drop and the foot and ankle to roll inward because the first metatarsal is not properly weightbearing. This applies to about 80% of the population when they are walking on a flat surface. Most people find over-pronation uncomfortable, so they subconsciously use their muscles to compensate by shifting more weight to the outside of their feet. They are trying to supinate their feet, but that puts more pressure in the area between the 3rd and 4th metatarsals and may cause the nerve to become trapped. Not everyone will develop a neuroma because of this compensation, but it is the cause of multiple other problems like metatarsal stress fractures, leg cramps and painful taught muscles, instability, metatarsalgia and more.

The Solution

No surgically removing the nerve, shooting it up with steroids, pain killers or sclerosing compounds is not the solution. A surgically snipped nerve can and often will restore in time. A removed nerve will leave a bare nerve ending. Steroids can provide intermittent relief, but the only permanent solution is getting to the root cause which is the supinating compensation pattern. Look at your shoes. Do you see slight lateral wear pattern, or high wear right in the middle under the balls of your feet? Another indication you are trying to supinate. Do you have tight calf muscles?

Beating the Pain

That’s where ProKinetics Insoles come in. The objective is to cure the foot from the lateral pressure that caused the neuroma pain in the first place. Podiatrists do not know how to do this, and those who do won’t mention it because it’s too inexpensive. Certainly, their $350 custom arch support orthotics only forces your feet to the outside. ProKinetics employ a totally different technology based on neuromuscular stimulation rather than structural support. It works better, is less expensive, has been used for over 20 years and is guaranteed to work or your money back. Get that guarantee from your podiatrist? Didn’t think so, but you will from us.