Inflammation on my foot, neuroma or something else?
(Lake Forest, CA)
I have inflammation on my ball of the right foot, around the area between 2nd toe and 3rd toe. and also the base of 2nd toes when you look down from above. I do not feel sharp pain. I just feel as if I am standing on a cushion underneath of the ball of the foot. No numbness or tingling sensation. The joint between toes and foot hurts when bending the towes upwards or pressing the area. Otherwise, I can walk and even run. When I planter flex, I feel pulling sensation no pain from the toe to the arch area on the bottom of the foot but no pain.
I believe that I injured my foot when I was taking a SHIATSU massage class. It was a massage work on the floor mat and required me to do a lot of squatting, bending my toes and putting all of my weight on the metatarsal head joints.
I have been to two different podiatrists. To both doctors, I explaiend how I thought I hurt my foot. The first doctor did not take an X-ray and diagnosed as neuroma, even though the location is off from typical neroma cases. He gave me cortison shots 3 times and ultra sound treatment. It got better temporary but did not cure. I went to see another doctor to get the 2nd opinion. This doctor took an X-ray and pointed out that inflammation from a nerve having neuroma should
not be causing inflammation of the tissue around it, however, he also diagnosed it as neuroma. In the X-ray, there is no broken bones, bone spur, or anything. He mentioned that there was a bit more stress on my 2nd metatarsal area. He gave me an alchole injection and taped a pad on my ball of the foot.
From the type of pain I have and the cause of the injury, I would think it is more like sprain in a ligament. I suspect that exessive bending of these toes caused the ligament(s) to overstretched and became inflammed. Isn't it more like Capsulitis?
I am worried because I read some articles of misdiagnosis for neuroma when it was actually not. If I had something like planter sprain, getting injection to the area directory could cause a tear and make it worse. What should I do?
Any advice would be very much appreciated.
Capsulitis certainly would be at the top of my list. The cortisone injection you had would also be indicated for capsulitis, but the denatured alcohol injection would not.
I would have your doctor add a metatarsal pad to your shoe or a temporary orthotic and see if that helps eliminate the pain. The fact that bending the toes upwards yielding pain makes your symptoms more consistent with capsulitis rather than neuroma.
If you get no satisfaction from either doctor, do not be shy about getting a third opinion.
Marc Mitnick DPM