tingling then turning to a burning feeling in my ball of my foot under my baby toe and the one next to it

by Sue
(CA)

I went for a 2 1/2 walk a few weeks ago. About 2 hours into the walk my ball of my foot and last two toes started having a burning sensation. We did walk on cement side walks the entire time. When I play tennis after an hour of hitting balls the pain starts up again so that I have to stop because I can't put weight on that foot (left foot)

I have had IT band issues. Is this related? How can I get the pain to go away?

RESPONSE

Hi,

Obviously, I cannot make a diagnosis from the other side of the internet, but your symptoms are highly suggestive of a neuroma.
A neuroma is basically a pinched nerve that occurs between the metatarsal bones. Typically, the ball of the foot is where the neuroma will occur and so in your case the burning will start there.
In most instances, the symptoms (in your case burning) tingling, pain, numbness as well will travel into the adjacent toes that are affected by the particular nerve.
The classic neuroma occurs in the third intermetatarsal space (in between the third and fourth metatarsal heads) sending symptoms into the third and fourth toe.
In your case it sounds like the fourth intermetatarsal space is involved and thus you are getting burning into the fourth and fifth toe.
I assume when you went for your walk, your were wearing sneakers or at least good walking shoes. One of two things may have occurred.
The first is your shoe may have been too narrow and thus the fourth and fifth metatarsal bones were squeezed together, putting pressure on the nerve and giving you the symptoms that you experienced.
The other possibility could be an issue with the sole of your shoes. Since the nerve is on the bottom of the foot, if your soles were either too thin or perhaps too flexible, both those issues could aggravate the nerve as well and give your symptoms.
A much lesser consideration would be a sub-metatarsal bursitis. A bursitis is a sac filled with fluid that acts to cushion an area, however, if the area is irritated it can become inflamed and create swelling in an area. In this case swelling of a bursal sac could put pressure on an otherwise healthy nerve, but give you neuroma symptoms.
Fortunately for you at this point, it takes some kind of prolonged activity for the symptoms to start up. This a good thing in the sense that most people with neuroma pain basically experience their symptoms almost as soon as they begin to walk.
The only way to relieve your pain is first to have a proper diagnosis. So, my best advice to you would be to see a podiatrist in your area to confirm the diagnosis of neuroma.
There are various ways to treat a neuroma, ignoring it is not an option as I would suggest to you at some point it may worsen and of course the worse the problem, the harder it is to remedy.
My favorite treatment for intermetatarsal neuroma is the use of 4% denatured alcohol injections. These are usually a series of injections whose purpose is to sclerose or deaden the nerve.
I find this treatment to be highly successful in the majority of cases and in the seven to eight years I have been giving these injections, I have only had to surgically remove a handful of neuromas.

Marc Mitnick DPM
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