Numbness of toes

by Ron Russell
(Pacific Grove, CA)

Numbness of Third and Fourth Toes and Metatarsal Second Question

Thank you for your opinion. May I ask another question? Another doctor agreed with your opinion that my podiatrist likely injected the steroid directly into the nerve, which is why my foot became five times worse. However three other podiatrists have only suggested orthotics, which I already have and which I can no longer wear because they increase the intensity and width of the numbness. They also suggested taping my foot, but that too did not help, and actually worsened it. You said in your first reply that there is a treatment. Can you please tell me what that might be?
I am fighting a rare form of blood cancer and this foot problem is inhibiting my ability to try to maintain some degree of exercise and conditioning. Ironically, I am on an experimental drug at the Mayo in a clinical trial and the drug has helped me greatly. Right now the foot problem is my major concern. The foot problem is not connected to the blood cancer. I have tried everything, including a prescription of Neurontin, and anything you can buy in a drug store over the counter. Ice, heat, ultrasound, a post-op shoe, and even a laser light treatment from a chiropractor. X-rays and an MRI show nothing.
I greatly admire someone like you who would donate and dedicate so much time and effort to helping strangers with no compensation. Truly, it is uncommonly kind. And your site is so intelligently arranged. Ron Russell

Hi Ron,
Thanks for the kind words; I try! Anyway, I do not believe orthotics or padding of any kind is going to give you any kind of prolonged relief, so there are three options.
I do not know if your blood cancer would allow it, but you might want to consider having the neuroma surgically removed. (not knowing what type of blood cancer you have I do not know if you are a candidate).
A second, more conservative option would be the use of denatured alcohol injections which I particularly like, for the simple reason that it has a high incidence of success.
Four percent denatured alcohol along with 96 percent local anesthetic is injected directly into the nerve on a weekly basis, anywhere from one to seven weeks. The purpose of the injection is to sclerose or deaden the nerve. (Re-read my section on Morton's neuroma). Since your neuroma has been exacerbated by it being "punctured" I would think the denatured alcohol injections might be a great alternative.
I also discuss the use of cryosurgery whereby a probe is inserted into the neuroma and the growth is "frozen" in an effort to eliminate the pain. Truthfully, I do not perform this type of procedure but it too is a conservative invasive means which may prove very helpful.
Before delving into these option check with your hematologist as to whether or not you are a candidate for any of theses treatments.
Good luck.
Marc Mitnick DPM