Are you dealing with pain, burning, tingling or numbness between your toes or in the ball of the foot? If you said “yes” then you could be dealing with a neuroma, a pinched nerve or benign tumor of the nerve that is often found between the third and fourth toes.

The classic symptom of a neuroma is pain, particularly when walking—a factor that leads many people to liken the condition to feeling like a pebble is in their shoe. You may find that the pain eases up whenever you aren’t walking or when you rub the pained area with your hands. While neuromas can happen to anyone, they are most commonly found in women.

Neuroma Causes

While the causes of a neuroma are still not clear, there are factors that can increase the likelihood of developing one, such as:

• Extremely high arches
• Flat feet
• Trauma that leads to nerve damage in the feet
• Improper footwear (high heels over two-inches tall; pointed toes)
• Repeated stress placed on the foot

Treating a Neuroma

A neuroma will not go away on its own, so it’s important to see a podiatrist if you are experiencing any of the condition's symptoms. The type of treatment or treatments recommended to you will depend on the severity of the neuroma.

Those with minor neuromas may be able to lessen symptoms by wearing shoes that provide ample room for the toes and offer thick soles that provide more support and cushioning for the toes and balls of the feet. Sometimes a podiatrist may recommend custom orthotics to place inside the shoes, as well.

Your podiatrist may also recommend padding or taping the ball of the foot to improve faulty biomechanics and reduce discomfort. While medication will not eliminate the problem, it can temporarily alleviate symptoms. Over-the-counter anti-inflammatories can often briefly reduce pain and swelling, but for those dealing with more severe pain, steroid injections may be necessary to ease symptoms.

Surgery for a Neuroma

Surgery only becomes necessary when conservative treatment options have failed to provide relief, or when the neuroma has progressed enough that conservative care won’t be enough. During surgery, the inflamed nerve is removed through a simple outpatient procedure. Afterward, there is a short recovery period of a couple of weeks before patients are able to move about pain-free once again!

Give us a Call!

If you are dealing with new or worsening foot pain it’s important that you turn to a podiatrist that can help give you the answers you need. Schedule an appointment today.

Many patients have reservations buying custom orthotics when they can purchase an inexpensive insole from the local drug store. This week, I thought I’d talk about the available options, and the differences between the two products.

Custom Orthotics, while more expensive, are designed for you based upon an impression of your foot. There are various ways to take an impression of your foot, with most podiatrists using either the traditional plaster slipper cast, or a newer 3D scanner. These impressions are sent, along with special instructions, to labs that specialize in making orthotics. The podiatrist can specify the material the orthotics are to be made out of, the requested length of the orthotic, and modifications for specific conditions like a neuroma pad, all according to patient need and preference.

Over the counter insoles, while much less expensive, are not customizable. Instead of making an orthotic directly for your foot, you have to choose from a variety of standard options which one would work best for you. There are many different brands of insoles, and some brands are better than others. Different products aim to treat different conditions, and so it may be difficult to find an insole that has all the corrections you might need.

Some people with minor foot problems may be able to get away with purchasing a prefabricated device. But for those with more advanced deformities, or conditions such as diabetes, there is no replacement for a custom orthotic. You can think of custom orthotics as an investment in your foot health; while they might be expensive, they last a long time and offer more than their over the counter counterparts.

Feel free to make an appointment with myself, or any of our doctors to discuss your options with us in any of our offices: Troy, Piqua, Sidney and Huber Heights, OH.

Eric Polansky, DPM

When the weather gets warm, both men and women ditch their more constrictive footwear in favor of the foot-freeing flip-flop. Flip-flops offer some protection for your feet, and thus they are better than walking around barefoot. They are fine to wear at the beach and public pools, as they can protect your feet from hot sand and concrete. They are also great to wear in public showers, often found in locker rooms at the gym and at the beach, to protect your feet from Athlete’s foot.

Flip-flops, however, are not meant to be an all-purpose summer shoe, and can cause several foot problems if worn too much. Because they are flat, they do not offer much arch or heel support, which can lead to foot pain. The thong can irritate the space between your toes, and can lead to a neuroma. The gripping action your toes must do to keep the flip-flops on your feet can be a contributing factor to hammertoes.

With these in mind, we at Advanced Foot & Ankle Care want you to be sensible this summer when wearing flip-flops. First, try to find flip-flops with arch support. If you are having difficulty finding a suitable pair, myself or one of our podiatrists would be happy to give you their recommendation. Second, consider switching to a “slide” type sandal to prevent irritation between your toes. Third, and perhaps most importantly, avoid wearing flip-flops for long periods of time; flip-flops are great to wear at the beach and at the pool, but they are not meant to be worn all summer long.

Eric Polansky, DPM

Steven Tyler, of Aerosmith and American Idolfame, is a famous sufferer of a common foot problem known as a neuroma. A neuroma is a thickening of a nerve as a response to irritation, and can be very painful. Most people with this condition describe pain or tingling between their toes, most commonly between the third and fourth toes. The pain can also affect the ball of the foot, and usually gets worse when bearing weight on this area.

One of the most common causes of a neuroma is shoe choice. Women are more likely than men to develop a neuroma, due to wearing high-heeled shoes. These types of shoes crowd the toes together, and cause the nerves of the feet to become “pinched”. This pinched nerve will thicken due to pressure, and will cause pain. Because of this, switching to more sensible shoes, such as shoes with a low heel and wide toe box, is recommended.

Shoe choice is not the only to blame, as those with flat feet or high arches are more likely to develop neuromas. Neuromas can also be associated with bunions, hammertoes, and other foot deformities. Custom orthotics can help correct some of these problems, and thus decrease the chance of developing a neuroma.

For our patients at Advanced Foot and Ankle Care in Sidney, Ohio, with a neuroma, we recommend orthotics and three steroid injections over three weeks to take pressure off the affected area and get rid of the pain. This course of treatment works for the majority of our patients, but for the rest we prescribe an anti-inflammatory drug and recommend wearing a night splint for an hour a day.

In rare cases where these other treatments don’t fully get rid of the pain, we may recommend surgery to remove a portion of the irritated nerve. In this case, we will use your own stem cells taken from your blood to speed the healing process.

Eric Polansky, DPM

If you haven’t heard about Zumba, the high-energy aerobic workout that’s more like a dance party than an exercise routine, then you’ve probably been living under a rock for the past year.  An estimated 12 million people worldwide now do the cardio-dance classes that are a combination of merengue, salsa, and other Latin dances. 

Zumba is so much fun, it seems like everybody is doing it.  That’s where I, your friendly Podiatrist, come in.  A lot of the people who participate in Zumba are enthusiastic new exercisers who live an otherwise sedentary life.  Add their eagerness, inexperience, Latin dance beats, and bad shoes and you’ve created the perfect storm for a foot injury.   

If I had a dollar for every Zumba-induced foot injury I’ve seen I could pay for a month’s worth of Zumba classes at my local Urban Active.  The four most common Zumba-induced pathologies and injuries I see at Advanced Foot and Ankle Care are

• Plantar Fasciitis- Heel pain caused by an inflammatory process in the plantar fascia, a thick band of connective tissue on the bottom of your foot.

• Intermetatarsal Neuroma- Pain, burning, tingling, or numbness in the front of your foot or toes caused by thickening and enlargement of a nerve in the foot usually as a result of compression and/or irritation.

•   Tendinitis- Pain caused by injury and inflammation of a tendon, which is where a muscle attaches to bone.  The most common types of Zumba-induced tendinitis I see affect the achilles tendon and posterior tibial tendon.

•  Stress Fractures- Pain caused by a cracked or incompletely broken bone.  In my Zumba-ing patients the most common stress fractures I see affect the heel bone (calcaneus) or metatarsal bones.  Stress fractures are often the result of overuse or repetitive stress and are a notorious culprit of pain in people who start an exercise program and do too much too soon.

A more detailed explanation of each of these injuries and how we treat them can be found on our website (www.footandanklecare.org).

All is not lost though.  If you’ve avoided injury thus far or are recovering from a Zumba-related foot injury, there are several things you can do to stay injury-free to ensure that you are getting the most bang for your buck and the most benefit for all that sweating.

Your shoes (not your brightly colored leotard) are the most important article of clothing you wear to Zumba class.  The ideal shoes for Zumba are supportive, especially in the arch area.  The front of the shoes (where your toes bend) should be flexible.  Cross-trainers are great shoes for this type of activity because they allow side-to-side motion and don’t have deep treads like a lot of running shoes do.  This allows them to maneuver through the dance moves easier.  We have several shoe options in our office shoe stores in all three office locations (Huber Heights, Troy and Piqua) that are perfect for Zumba.  And as an added bonus, we have a helpful and knowledgeable staff to help you choose the right shoe. 

An orthotic, a custom-made insole, is also a great option to help prevent injury (especially in certain foot types) or to prevent re-injury if you are recovering Zumba-er.  Orthotics work to support your foot, reduce weight bearing forces on certain areas, and correct the function of the foot to make motion easier and less painful.  At Advanced Foot and Ankle Care we can provide you with a custom-made device that will change your life in and out of Zumba class. 

One of the best things about Zumba is that it lets you customize your own work out.  You can make the class high impact or low impact.  Some gyms now offer Aqua Zumba and  Zumba Gold- the low-impact version.  Be sure to tell your Zumba instructor about previous injuries or special health concerns like pregnancy.  Know your limitations and don’t start out too fast, even if it’s hard to control your hips with those infectious Latin beats blasting.

As always, it’s a good idea to consult your healthcare professional before starting any new exercise regimen. 

Dr. Hillarie Amburgey