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Hot Foot, Numbness, Morton's Neuroma....

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Hot Foot, Numbness, Morton's Neuroma....

Old 06-01-09, 06:15 PM
  #51  
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What a great thread on Morton's Neuroma

I'm a newbie who had to quit running due to a Morton's neuroma that didn't respond after two surgeries. I was wondering if I was going to be able to ride and this thread helped me quite a bit. My local bike shops never heard of shifting the weight to the arch (as suggested here) and I'm going to look into that as I plan to buy my first bike this weekend. The thread is almost a year old so, if anyone has any other info on the subject, I would greatly appreciate it.
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Old 06-02-09, 06:26 AM
  #52  
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Mexipat,
I'm another with Morton's neuroma and Plantar fasciitis. I tried home made pads, softer and harder shoes, stopped loafers and sandals, modified store-bought inserts, custom shoes, moving the pedal cleat aft. I did find moderate relief with most experiments but overall things worsened. It got so I couldn't stand bare foot on any hard floor and couldn't walk or run. The podiatrist said all my experiments were classic behavior and made custom orthotics (from a non pressurized foot position), gave me exercises. I do execises, Advil, use Specialized's most aggressive inserts* in my custom molded Shimanos, cleat aft, exercises, ice and Advil as needed and wear my orthotics all other times. The orthotic doesn't work well in some shoes and I still can't stand still for long. At museums, I'm like a shark circling in search of the next vacated spot on a bench.

*interesting the podiatrist said custom orthotics don't seem as critical in bike shoes. It is critical to wear the orthotics in all off-bike shoes.
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Old 06-02-09, 07:07 AM
  #53  
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Interesting original post and thread.

The whole racing and maximum performance mentality is causing a lot of problems among recreational cyclists, in my opinion... problems that used to be more the exclusive province of pro racers.

Riding positions are too aggressive, first of all. Saddles are set for performance, ie, too high. This is combined with clipless pedals and the stiff shoes that go with them. The results are twofold. People are so high on the bike that they inevitably end up pedalling excessively toes down. You can see them looking like they are reaching and pedalling on their tip toes. Then, you've got the foot locked into and onto the pedal, so that this tip toe pedalling keeps the ball of the foot permanently compressed onto the pedal at all times for rides of many miles. Of course, it's not just clipless, because toe clips as were used by racers (ie. strapped down and with cleats) do the same thing.

Most people would be so much better off in the long run if they gave up a bit of power and set themselves up more in the traditional French style, which satisfies itself with a saddle height which is based on the heel-on-pedal method. Even today, almost all French websites and other documentation oriented towards cyclotourists suggest this. Why? Because it's reasonably efficent and comfortable, while ensuring that riding position is not extreme enough to cause any stress injuries such as tendonitises everywhere, foot problems, etc. Unfortunately, everyone in America seems to insist on identifying with racing. There isn't a sport on the planet which doesn't require competitive athletes to give up something for the extra performance. What they give up is the healthiness of the activity.

Even if we ride many miles, almost every day, we're still recreational cyclists. There's nothing derogatory about that term. When I talk about "French fit", I'm not talking about what Americans think it is, like overly large frames, and high handlebars. I'm talking about a more moderate riding position, and I'm talking about enjoying the cycling itself rather than the performance.

Last edited by Longfemur; 06-02-09 at 07:10 AM.
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Old 06-02-09, 07:11 AM
  #54  
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Originally Posted by mexipat View Post
Morton's neuroma that didn't respond after two surgeries.
Find another podiatrist...

Have you had an MRI/ultrasound...



The recommendations in this tread are very good...
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Old 06-02-09, 07:56 AM
  #55  
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I've tried a lot of things

The two surgeries were done by orthopedic surgeons, the second one also takes care of the Miami Heat so they seemed pretty competent. I've also done acupuncture. One think I didn't do faithfully is the ibuprofen/ice combo so I'm going to try that again before doing anything invasive. I've read mixed reports about the alcohol injection procedure.

I'm about to buy my first road bike and start riding and am hoping it will be easier than running. I'm ok on an elliptical trainer but that's an entirely different animal.
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Old 06-02-09, 07:58 AM
  #56  
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I've never heard of the heel on pedal method but will learn about it now.
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Old 06-02-09, 08:08 AM
  #57  
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Also consider these: Aline footbeds http://www.aline.com/about-aline/about-aline
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Old 06-02-09, 08:19 AM
  #58  
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I wish I caught this thread last year!

I've been battling numb toes in my right foot since I started road cycling. At first it took 60-70 miles before a flare up. Now it happens sooner. This was never a big deal to me until I started racing and doing long endurance rides.

Early this year I was determined to solve this problem. I started by getting slightly larger shoes (Specialized Pro) then started playing with the cleat position. Moving them all the way back helped. I then started playing with the Lemond Cleat wedges. Things improved but the problem was not solved. I even bought some metatarsal pads to place under the insoles for more support.

Now I am using a combo of shims, pads, and additional arch support (I use blue on the left and green on the right). Without the shims, I can feel my ankle rolling with every power stroke. This is the root of my problem. With a couple cleat shims, I can get the numbness to go away at the expense of knee pain.

I finally scheduled an appointment to see a podiatrist who makes custom orthotics for cyclists and runners. I really hope this works, as it's not cheap! I thought I was the only one here with this problem. I'll report back after I get my custom insoles made....
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Old 06-02-09, 11:04 AM
  #59  
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Originally Posted by Longfemur View Post
Addition to my post above:

I'm only suggesting a more modest riding position. I'm not advocating against anything, including clipless pedals. All I'm saying is that most of us "recreational" riders should consider trading in some performance for more long-lasting comfort and injury-free riding. That would mean saddle a little lower than some of today's popular calculation-based methods would suggest, and also perhaps handlebars a little higher than what is provided by most racing-like bikes on the market. An inch below the saddle should be plenty, unless the person is tall. Clipless pedals are fine, but cleats should probably be a little further back, so the ball of the foot is not dead-on centered over the pedal spindle. You should also pedal as lightly as you can for the conditions: favour spinning over mashing - but avoid extremes. You're not Lance Armstrong. Moreover, no matter what you do, stop and take breaks off the pedals and off the saddle. Relax a bit and enjoy yourself... riding shouldn't be a permanent competition. Think of baguettes and wine rather than power bars and drinks (not literally, necessarily, just as a frame of mind). If necessary, avoid clubs and groups which don't share the right frame of mind.

If you have pain or numbness anywhere, as I've posted before many times, don't suffer through it. Accept it as a sign that something you are doing is wrong. Most North Americans are relatively new to cycling as adults. As with anything else, it's all about performance and numbers. All well and good, but it could be infused with a little more maturity. I don't mean that in a bad way, just that much of the advice you can read on the internet, and other riders you might ride with, are much more performance-oriented than is useful for most recreational riders (and recreational does not mean leisurely). And then you've got the other extreme, which would turn your nice road bike into a hybrid. That won't work either for frequent riding over long enough distances to take a couple of hours or more.
Pontificate much?
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Old 06-02-09, 11:29 AM
  #60  
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Thanks for the thread and calling attention to this issue.

I've been fighting this problem for years, but thankfully, no Morton's yet, just numb toes on the ride. It happens 37 minutes into any ride.

I have seen improvement with the LeMond wedges, Specialized insoles and a rearward cleat. I bought bigger shoes with a wider toe box. Currently running Superfeet Yellow footbeds, Specialized red insoles and 2 varus wedges beneath each cleat.

This past weekend, I also tried curling my toes up towards the top of the shoe while still pedaling. This took a bit of concentration and I would not want to do this all the time, but it allowed the numbness to recede. Toe curling combined with "making fists with your toes" helped me.

So, based on this experience, I'm planning to make a little foam shelf for my toes to rest on keeping them off the bottom of the shoe. I guess I tend to press my toes to the floor of the shoe on each downstroke.

While I think all of this alignment and support technology should help, I seem to be lacking in pedaling technique too. Spinning more seems to help.

What a frustrating PITA!!

+1 on the suggestion to NOT just accept numbness. Keep tweaking until you fix it.
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Old 06-02-09, 02:14 PM
  #61  
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Mexipat...thanks for reviving this thread. The intent behind writing it initially back in July of '08 was manifold...partly explain what I had learned through cycling and injury, share my progress and setbacks and also sollicit further advice and suggestions. I have learned that foot injuries in cycling like running are as common as milk...and most self induced by poor mechanics and wrong shoe selection. Mexipat...I am sorry to hear of your injury and my intent is to provide hope. Just under a year later from writing this thread, I sit here and am pain free. That's right...virtually no foot issues to report. This is from a guy who didn't know if he was going to be able to participate in something he loved...cycling, or even be able to walk without pain. I was hobbled. So...this thread was partially a revelation and partly a cry for help. My road back involved no surgery. I was on the brink of signing up...to either be cut or at least alcohol injections. I was pretty desperate. I now can walk in supermarkets or the airport today and not feel a single shooting pain...something that was common a year ago. I was fearful I was going to get to the point where I couldn't walk very well. This is from a relatively healthy athletic guy. I don't even think about Morton's anymore. If you have this issue, I strongly urge you to change your habits immediately. I suggest in fact to do what I did...purchase some platform pedals and comfortable tennis shoes with a lot of room in them. You need to change the muscles in your feet. You need to reshape the arch that was torn down by the repetition of constant cycling in hard sole shoes with an improper foot support. Rest over the winter...always trying to properly support your feet and you maybe lucky myself to recover fully without surgery. Today I am riding as well as ever in Specialized Sworks Boa carbon fiber shoes with Speedplay zero cleats with rear extension plates to move the cleats back. I have learned that it is just fine to have rigid shoes provided the support underneath is comprised of a shape that will not compromise the nerve structure of your feet when pressed highly under load on a continuous basis as with cycling.
So the best advice I can bring aside from all the discussion in this thread...is a message of hope. Those that suffer with this can recover with the proper reversal of habits that created your foot to be mis-shapen by poor technique and shoe fit.
Longfemur I always enjoy your posts and thanks for contributing. I as usual agree with you. Hammertoe...thank you for all the great advice you provided as I struggled with this issue which was pretty scary at its worst.
Ride safe.
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Old 06-02-09, 05:27 PM
  #62  
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I see my new podiatrist tomorrow

And will talk to him about all options learned on this excellent thread. Thanks for starting it and I'm glad you are doing better.

Longfemur: If that's pontificating, have at it. I enjoyed the post, especially the baguettes and wine analogy.
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Old 06-03-09, 07:07 AM
  #63  
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Those with major foot problems should consider custom D2 shoes. They cost $675, but you get custom orthotics and a guaranteed fit. Be sure to tell D2 the specifics of your foot problem. They may tend to fit the shoes tighter than some can tolerate. I had them send me a stock pair of shoes in the size that they thought would fit best, to be certain before ordering shoes with custom colors. The custom orthotic takes up more room than their stock insole, so I found my custom shoes to be a tighter fit than the stock shoes.

Having a custom orthotic will transfer a lot of the pressure from the forefoot to the arch, without having to move the cleats extremely far back. If you specify speedplay cleat useage, they move the 3-hole pattern back about 5mm so the cleats can go further back than any Sidi shoe will allow.

http://www.d2shoe.com/index.php?page...chk=1&Itemid=1

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Old 06-03-09, 07:12 AM
  #64  
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ran across this article last week when debating on getting orthotics:

http://query.nytimes.com/gst/fullpage.html?res=9B01E4DE1F31F931A15755C0A9609C8B63&sec=&spon=&pagewanted=1
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Old 06-03-09, 07:40 AM
  #65  
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I've twice had a tendonitis problem that usually takes 3-5 years to cure. The first time was over 20 years ago and it returned again about 3 years ago when I neglected to wear adequate arch support in all of my shoes.

Custom orthotics can be had for around $130. I get mine from a local podiatrist. They cost about $300, but my medical insurance pays 90% of that. They work wonders for me.

The custom orthotic in a D2 cycling shoes adds $110 to the cost. Well worth that, IMO.

http://www.orthoticshop.com/custom-o...orthotics.html

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Old 06-03-09, 04:26 PM
  #66  
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I saw my podiatrist today. Got the first of a series of three cortisone shots and ordered orthotics for $420. I get fitted for them on Friday.
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Old 06-04-09, 06:31 PM
  #67  
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Wow someone dug this thread up from the past.

Mexi - did the podiatrist offer you generic medical-grade orthotics or did you spring for the custom ones right away? I usually try cheaper ones first - unless my patient is rich. I don't plan on doing "a series of 3" injections - I do 1 and then see how the patient responds. I usually do a 2nd. Sometimes I'll do a 3rd. If that doesn't help much I prescribe oral steroids. I usually also Rx ibuprofen, aleve, other NSAID's (in Rx doses, of course). I can't talk my patients into the scheduled series of 7ish dehydrated alcohol injections. I always have patients bring their bag of shoes on the 2nd visit and evaluate each shoe. Including cycling shoes and high heels.

Campag4life - sorry I didn't respond to your surgery question earlier. There are several surgical methods for treating a Morton's neuroma.
1) Excision. This is literally cutting out the nerve from in between the bones right behind the affected toes.
A) Incision from the bottom of the foot since that's where the nerve really is. Takes longer to heal. May scar. May not.
B) Incision from the top of the foot - traditional way.

2) Decompression
A) 9 mm incision in between your toes and taking a special knife to cut the ligament in between the metatarsal where the neuroma is.
B) Several small incisions and a camera in one hole and a knife in another hole to do the same thing as in A except your podiatrist can see exactly what s/he is cutting and maybe seeing the neuroma.

You should always ask your doctor how many of X surgeries s/he does and what their success rate is. I don't care if it's the Presidents doctor - it doesn't make that doctor experienced in the exact surgery you need. I would also add to always seek a board qualified/eligible/certified doctor in the area of your particular medical/surgical need.
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Old 06-04-09, 09:35 PM
  #68  
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Bontrager,

If your practice is in South Florida, I'd love to be your patient. The new doc did not offer me another type of orthotic. I didn't even know there was another. He also said I have inflammation but no longer have a neuroma (I've had two surgeries so maybe it's gone) and he believes the cortisone and orthotics will get rid of it. I'm wishin and hopin.
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Old 06-04-09, 09:44 PM
  #69  
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Hmm...Interesting thread. I have some nerve damage in my spine that has weakened and damaged the nerves serving my legs. I have a problem with my left foot and the way I walk such that a large callous is retained associated with 5th metat. But this cycling season I've had weird symptoms. After longish rides, the next day I'll be barely able to walk - the area around callous is just burning and hurts very much. But the next day or second day after the pain will be gone. In Marc it got so bad I had to quit riding for a few eeks at end of month and early April. I was thinking it was the callous, but the callous is always there - the pain would not come and go like that with a callous. I may go to my orthopaedic surgeon and inquire about a neuroma.
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Old 06-04-09, 09:48 PM
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Many cyclists have foot problems, some of which are caused by clipless pedals and cycling shoes placing too much pressure on a very small portion of the foot.

Solutions include using thick soled shoes (such as skate board shoes) or even a ultra-light weight hiking boot with a thick sole, combined with a high quality BMX pedal. The combination of a thick soled shoe and a BMX pedal spreads the pressure out over the entire forward portion of the foot. Make sure the shoes has lots of space, especially around the toes. Many cycling shoes are too tight, especially near the toes.

Also, using "easy" gears and a higher cadence puts less pressure on the foot than a "hard" gear and slower cadence. Try spinning as fast as possible in a easy gear.

A great pedal for use with any sandal, any shoe, or any boot is the "Grip King".

http://www.rivbike.com/products/list/pedals_and_so_on

Warning...the use of the "Grip King" pedals, combined with a light weight hiking boot or thick soled sandals will cause and "real" roadie to fall off his bike laughing. "Real" roadies will ONLY use shoes and pedals approved by Lance Armstrong.
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Old 06-04-09, 10:05 PM
  #71  
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I just had a Morton's neuroma removed. Not all that big a deal, but you want to avoid it if you can. My flareups were bad enough that I couldn't really walk.

Total time to recovery has been about four weeks thus far. For the first two, the wound was heavily bandaged and still healing. Third week, smaller bandage; fourth week, bandage off and moving around more or less normally. I'm still not at 100% but can ride, run, etc for moderate distances. I'll probably need two--three more weeks for a full recovery.
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Old 06-17-17, 06:00 PM
  #72  
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I have read this awesome thread twice thanks to Campag4life. Right now at age 61, I have a self diagnosed neuroma in my rt foot that has flared up again and not as severe metatarsal pain in my left. For years I've battled with this including severe ball of foot pain, and the only relief came from stretching the shoes, higher and higher arch supports(A la Steve Hogg's suggestion) and metatarsal pads. I've had my cleat back for years and have drilled back my Shimano 3 bolt Look style cleat 2 different positions, but still the pain persists. So now I'm ready to put on the platforms and soft-sole running shoes and met pad and arch support and let my feet recover. After recovering, I see the following choices:

Spend 375 for a fit and another 170 for a orthotic made for my feet during the fit in DC to Parvilla Cycles, or go to Fitwerx in Vermont which offers similar pricing and orthotic, or go see Jerry Gerlich(one of Steve Hogg's students) in Austin Texas for a even higher price for a fit and a very detailed foot analysis with shims etc. but not custom orthotic

Or, get a D2 shoe for $925 which comes with a custom footbed and then pay $250 for a fit here in Richmond,VA(no fits with custom footbeds here in Richmond). I haven't had a in-person fit with the current bike I have except a on-line video fit with a bike coach, which included a varus analysis through the free Bikefit app.

Or get a $250 fit here in Richmond and get the Specialized S-works and do my own orthotic if what comes with it doesn't work. (I'm getting the sof sole highest arch thin fit next week, I have a met pad that works pretty good)

My main concern and confusion is that despite several professional fits, my foot pain hasn't gone away, it got better when I found one time my saddle was too far back and the fitter moved it forward. So will a bike fit really help, or is it more the foot/shoe? I have tried the Lake Wide 237 recently, but it was really the same width as my shimano wide RP300, and no noticable difference in lessening the foot pain.
Steve Hogg is 99% confident that he or one of his students can get me right on the bike so I won't need custom shoes, yet the flight to Texas and the fit would prob equal the cost of the D2. Then again, how long will it take to get the D2 right??

Any thoughts or suggestions would be greatly appreciated!!

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Old 06-18-17, 01:24 AM
  #73  
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This thread should be pinned as a permanent thread. Good info from good people.

This past winter, I started experiencing the very first signs of Morton's neuroma - a feeling that there was a piece of yarn in my sock (right foot). Very mild but annoying. I kept taking my shoe and sock off looking for an intruder, but nothing was there.

Then I started buying new socks thinking my old socks were just stretched out and bunching under my toes/ball of foot. Nope. I tried thick socks, thin socks and double layers. No improvement.

Finally started buying new shoes. Tried sandals, running shoes and slippers. No improvement.

My symptoms are annoying but not painful. I think it's time to see a podiatrist.

Thanks for the thread, even though it's old. Like me .
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Old 10-23-17, 06:00 PM
  #74  
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Excellent and timeless thread. I have been fighting a large neuroma this year which I can't quite figure out "why now?". I have been actively cycling for 35 years and have well over 100,000 miles in the saddle. I haven't changed shoes in over 3 years and my yearly mileage and riding habits haven't changed.

Anyway, my question isn't why now, it's what's next?

I have been to the podiatrist and have done the cortisone injections (resulted in temporary relief), neuroma pads (a little help), custom orthotics (some relief), and different shoes (worse), and NSAID's (just masked the pain), but in general things are getting worse. I will try relocating the cleats next, but that about exhausts the list.

At this point I am seriously considering surgery. The neuroma has gotten so large that I can feel it and can push it around a bit. My podiatrist has said that a neuroma will never heal and if all the other things don't work, surgery is the last resort.

So my question is around surgery. I gathered from this thread that there was slightly more positive results than not from surgery, but most of those comments are 7-8 years old.

So have others had the surgery? What have been your experiences? Any loss of feeling, or other side effects? Any new wisdom or lessons learned you can share?

TIA
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Old 10-24-17, 03:50 AM
  #75  
ModeratedUser17082018
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I'm just now getting x-rays for the foot doc to address my foot discomfort. I hope for relief soon. My case is not bad but annoying.

Alcanbrad - Regarding your more serious situation, surgery may be the answer and a second opinion might be helpful at least for peace of mind.

My mother (now 89 and still walking just fine), had 6 neuroma's removed on the same day many years ago. She has had no issues or further pain since then and it's been over 50 years ago.

So even if you have to have surgery, the outcome might be really good. Let us know how it goes.
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