pain in ball of foot going into toes

I have excrucitiating pain starting in ball of foot irradiating into toes, more noticeable during excercise, does pose a problem and have had to cut my workouts down in time because of it. Family is noticing that I am starting to use the opposite foot/leg more and somewhat of a limp in affected foot/leg. While at rest I can put pressure on ball of foot and make the pain return. The pain is kind of like when foot falls asleep and you get the pins and needles effect. I have not broken any bones nor sprained anything and there is no swelling.

RESPONSE

Hi,

Obviously, I do not have the luxury of actually examining you, but based on your narrative you appear to be describing a classic Morton's neuroma.
A neuroma is basically a pinched nerve that occurs on the bottom of the foot where the nerve runs between the heads of the metatarsal bones (ball of foot) and then divide to go into the toes. From pressure against the metatarsal bone heads, the nerve gets irritated, it begins to thicken and at some point will create varying types of pain, anywhere from very sharp pain in the ball of the foot that may travel into the toes. Sometimes the pain can be so bad the pain will also travel backwards into the foot, although this is not seen frequently. Other types of sensations include burning, numbness and tingling. These are all nerve type pain and seem to be how you are describing your symptoms.
Activities such as working out may certainly aggravate the problem. Wearing thin flimsy dress flats may also aggravate the problem as well as walking barefoot.
Although your description certainly sounds like a Morton's neuroma there are other conditions that may mimic these symptoms to a lesser extent. These would include an intermetatarsal bursitis, metatarsalgia and capsulitis. You can read about all these conditions on my site.
Assuming you have a Morton's neuroma there are various treatments depending on the degree of pain you are experiencing.
Sometimes anti-inflammatory medication, assuming you can tolerate them, will go a long way in reducing pain. An orthotic (arch support) with a metatarsal pad built into it may also help alleviate the pain as the metatarsal pad helps spread the metatarsal heads just enough to take pressure off the nerve.
The more painful the growth, the more aggressive treatment has to be. This may include cortisone injections, usually three over a three week period. My favorite treatment is injections of 4% denatured alcohol. The alcohol scleroses or deadens the nerve and therefore the pain is alleviated. The injections can range any where from one to seven over a seven week period. I have had a lot of success with this form of treatment.
In those cases where all conservative treatment fails, surgical excision of the nerve is then indicated.
But first you need an accurate diagnosis. I would suggest you see a foot specialist in your area, get a proper diagnosis and then appropriate treatment.

Marc Mitnick DPM
DISCLAIMER