Here’s a question I get pretty often: why feet? And I answer, because I love feet. And usually I’ll add a comment about how it’s a good thing I’m not a gastroenterologist or a urologist or something along those lines.
An interesting picture of Steven Tyler, lead singer of Aerosmith, has been circulating recently. Said picture shows his toes going west, young man, with a surprising degree of overlap, and toenail polish. Dude looks like a lady, indeed. Apparently the deformities have been attributed to a Morton’s Neuroma and the surgery which Steven underwent to remove the neuroma and, according to his book, some of the surrounding bones. Well, the surgery itself may have disrupted some of the ligaments and tendons that hold the toe in a straight position, but as far as the neuroma itself leading to those unhappy feet, all I can say is- dream on.
What is a Neuroma?
A neuroma is a condition I see very commonly in my NYC podiatry office, in which a nerve in the ball of the foot becomes inflamed and swollen, leading to symptoms including pain, burning, tingling and numbness- certainly not a sweet emotion. The most common location is in between the third and fourth toes, followed by the space between the second and third toes. Tight shoes and heels tend to aggravate the condition, and wide shoes usually relieve the pressure and pain. The condition is diagnosed through the history and location of the pain, and ultrasound and MRI can have some role in clarifying the diagnosis.
How is this treated, and can I still have love on an elevator?
Not sure about the second part. Initial treatment usually involves an injection of cortisone, as well as some strategic padding and the use of a comfortable shoe. If that fails, the nerve can be surgically removed or released. In my NYC podiatry practice, I tend to favor multiple cortisone injections. While they are decidedly not terribly pleasant, in most instances the pain is relieved by this method, and my patients would usually take any number of injections to avoid surgery, and I tend to agree. I rarely remove the nerve, and tend to favor a newer procedure that allows me, through a very small incision and with endoscopic assistance, to cut a ligament that exerts pressure on the nerve. This technique relieves the pressure while preserving the nerve.
So if you’re feeling a burning or aching pain in your forefoot, don’t keep “Livin on the Edge”, because that’s just “Crazy”. Seek treatment while the problem is still manageable.
See you in the office.
Dr. Ernest L. Isaacson
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