Neuroma

Neuroma

If you’re a woman with sleek black heels in your closet, you may be tempted to put them on again—perhaps many times—if they look good with your outfits.

But maybe those shoes don’t belong on your feet again. In fact, you may want to consider offering them for sale with your next batch of yard-sale items. Or, at least, relegate them to the back of the closet and trot them out only on special occasions.

Sometimes, shoes are saboteurs. They may be the very shoes that are causing or contributing to a painful foot ailment called Morton’s neuroma, says Wilford K. Gibson, M.D., assistant professor of orthopaedics at Eastern Virginia Medical School in Norfolk.

If you’ve been wearing high heels or ill-fitting shoes for a long time, you may already be familiar with the symptoms, which afflict more women than men, Dr. Gibson says. Don’t be surprised if you’ve had cramping, pain, numbness, tingling, or burning in your forefoot, often between the third and fourth toes. The reason is that those troublemaker shoes compress or squeeze the nerves between the toes, causing the nerves to swell.

Neuromas can occur between your other toes, too, says Donald G. Hovancsek, D.P.M., podiatrist in Olympia, Washington, and a spokesperson for the American Podiatric Medical Association.

Your chances of developing the condition increase with age, whether you are a man or a woman, Dr. Hovancsek says. That’s because the fat pads on the bottoms of your feet become thinner as the years pass, leaving you less protected from knocks and bumps. Also, your Achilles tendon, which attaches to your heel, often shortens over the years, putting more daily pressure on the front of your foot, which can also cause neuroma pain, he says. Water retention or other causes of swelling, such as arthritis, can also put pressure on the nerves in the foot.

Symptoms may come and go depending on your activities and choice of footwear, Dr. Gibson says. But those symptoms are more likely to linger and scar the nerves if you just limp along and ignore them. Some people require physical therapy, steroid injections, or even surgery if the neuroma is allowed to get its way. So check out the following simple tips for preventing or easing Morton’s neuroma. And then take a peek in that closet.

Try This First

If the shoe doesn’t fit, don’t wear it. In most cases, symptoms will subside when you change your shoe, Dr. Gibson says. “Go for comfort over looks for daily wear.” Choose a shoe with a well-cushioned sole and heel, wide toe, and sturdy arch. A lace-up provides more support than a slip-on, he says.

Consider wearing an athletic shoe, something with a woven leather toe, or a thick-soled earthy-style walking sandal, Dr. Hovancsek says.

Other Wise Ways

Try stretching. If you’re developing a neuroma or have a neuroma with numbness and tingling but not too much pain, these three simple stretches, each performed for a minute or so several times a day, can help, Dr. Hovancsek says. If done correctly, you should feel a stretch in your Achilles and leg muscles.

• While holding on to a sturdy railing, stand with your toes and the balls of your feet on a bottom step (never a higher one), with your heels over the edge. Slowly rise on your toes and then descend until your heels are below the step.

• When you’re in your kitchen after washing dishes, take a couple of steps back from your work, dry your hands, and then lean forward while holding on to the sink. Bend one knee, raising your heel off the floor, and then the other, and continue in a peddling motion. Keep your head up, looking toward the window or wall.

• For an exercise that’s more challenging, sit on a straight-back chair. Raise one leg until your thigh is not supported by the chair and your knee is locked. With your toes pointed toward the ceiling, move your foot in a circle, as if your big toe were a hand on a clock.

Revive your routine. If you have pain during exercises like running or walking, shorten or change your activities until your discomfort subsides, Dr. Gibson says. But don’t use the pain as an excuse to stop exercising. Switch to swimming or bicycling. When you return to walking or running, stay off hard surfaces, which can aggravate pain.

Do a shoe survey. Make sure your athletic shoes aren’t the cause of your discomfort, Dr. Gibson says. Don’t wear thin-soled shoes when walking or jogging, even if symptoms subside when you stop or remove your shoes.

Choose looser legwear. Tight-fitting or support hosiery can worsen pain in a foot that’s already been tortured by being stuffed in an ill-fitting shoe, says Dr. Gibson. Wear appropriately sized socks with athletic shoes.

Turn to the bottle. Over-the-counter medicines can be helpful. If your doctor says it’ s okay, try ibuprofen, enteric-coated aspirin, or acetaminophen for temporary pain relief and swelling, Dr. Hovancsek says.

Go for the chill of it. Apply an ice pack wrapped in cloth to your foot for up to 20 minutes at a time. This may reduce pain and swelling, especially if it’s related to activity, Dr. Gibson says. But be careful, especially if you have numbness, he warns. Some serious medical conditions, such as diabetes, may cause loss of feeling in the feet.

For a convenient ice pack that molds to your foot, freeze a bag of unpopped popcorn and place it on the affected area, Dr. Hovancsek says. Elevating your foot may also help reduce swelling.

Lighten up. Your painful foot is going to be a lot more uncomfortable if you are carrying more weight than you need to, Dr. Gibson says. As your foot strikes the ground when you walk, it carries the full weight of your body. If you run or jump, the burden can be four or five times your body weight. And since your little toes aren’t made to endure that kind of force, you’ll need to lose a few pounds to give them a holiday.

Examine your soles. Every six months, look closely at your shoes for signs of wear, especially in the soles. Worn-down soles or uneven wear might be inviting neuroma. “It may be time for a new shoe,” Dr. Gibson says.

Shoe shop toward dusk. When buying shoes, shop at the end of the day, when your foot is larger. “Your foot tends to swell with activity,” Dr. Gibson says. Also, take along the socks or hosiery that you’ll wear with the shoe to make sure that you have a good fit. And be sure to try on both shoes since one of your feet may be larger than the other.

Put your foot in the other shoe. Don’t wear the same pair of shoes every day. Instead, alternate your favorites with others in your closet, Dr. Gibson says. Not only will your shoes last longer, but you’ll be giving your feet a welcome break.