NY-euroma in my NY-erve

We are in the throes of Spring here in NYC, on the cusp of Memorial Day and the beginning of summer. The trees are budding, birds are chirping and the kids are getting super hyper and ready to be liberated from the shackles of the bondage we call school for another summer of mayhem and parental penance. And yet in the midst of all this, if you’re one of the 2-3 dear NYC podiatry patients that sees me daily for this particular condition, there’s this persistent nagging pain in the ball of one foot. What is it and what to do? That I can answer in one word- tradition! Well, not exactly, but it is a neuroma, and because it’s so common let’s dedicate this week’s holy and sacred blog to the condition and next week to treatment.

 

Back in the day there was a surgeon, let’s call him Thomas George Morton, because that was his name, who is credited for this condition, although it was actually elucidated by Durlacher. And if you haven’t had the pleasure, you likely will or will certainly know someone who has it. It’s a very common condition that involves the nerves in the ball of the foot. The typical presentation is burning or sharp pain in the ball of the foot in between the third and fourth or second and third toes, sometimes accompanied by numbness or shooting pain into the toes. High heeled or tight shoes can make it worse due to the pressure on the foot. Inside the foot the nerve that runs between the metatarsal bones, which are the long bones of the foot, becomes inflamed due to pressure from shoes, activity or life. Over time the nerve can develop a bit of a swelling that is visible on ultrasound on MRI, although often times the nerve appears completely normal, and in my NYC podiatry practice many non-painful incidental neuromas are seen on MRI’s that are ordered for entirely different reasons. Because there is a connecting branch between the two main nerves on the bottom of the foot at the space between the third and fourth toes, this is the most commonly affected area of the foot, followed by the space between the second and third toes.

 

Having a ball yet? Tune in next week when we talk treatments. Doesn’t get too much more exciting on a Memorial Day weekend.

 

See you in the office.

 

Ernest Isaacson