Mortons Neuroma?

[oldguy00]

Anyone here an expert on this?? :)

For the past 2-3 weeks I find my 2nd, 3rd and 4th toes on both feet, maybe a little worse on one than the other, have been sore....maybe burning soreness, under the pads. But no pain under ball of foot, and none in big toes or pinky toes.
Not really -strictly- burning and not tingling, not really any discoloration. But sore to touch.

Wondering if Mortons could explain this?

I have, also for the past several years I think had a bit of 'reynauds' (sp?) where if I am on a cold floor my toes can go blue, but this is different, no discolor and always sore.

In good shape, no history of diabetes or MS or ALS etc in family. Active triathlete so my feet do take a bit of a pounding.

Yup, I have a doc appt, but not for about 10 days, takes a bit longer in Canada..

Edit - I should also add that I do struggle with shoe width, both in forefoot and midfoot, and do have orthotics with met pads. I actually have the bunion area cut out of my shimano tri shoes. But the thing that puzzled me about this is that whenever I read about mortons, it always seems to reference pain under ball of foot radiating up to toes, but I don't seem to have that, just mostly the last like centimeter of the 2nd-4th toes.

Cheers

[soulspinner]

had the issue since the 80s when I wore racing shoes too tight. Went to a doc that was a foot guy and he said its too bad for cortisone. Went to a foot performance store and have used orthotics that take pressure off the area where the neuroma is ever since.

[Tickdoc]

Went through this six or seven years ago. It was a painful annoyance. I visited a foot dr and had custom orthotics made. Wore them off and on for about a year and it eventually went away. Every now and then I will feel it try to flare up, but it hasn't gone full blown like it was. I remember it being a painfully hot pain centered right between the third and fourth toe connection to the foot. It would feel like it was on fire and was very painful at times.

May sound crazy, but I think mine was caused by a certain brand of shoe? (Timberland)I can't confirm this, but at the time I has three or four pairs of shoes from them and it coincided with the morton's. I wore the orthotics with all my shoes, even cycling, and eventually went away from those shoes and now I am good.

I discovered through that process that a metatarsal bump helps my feet when cycling and that Lake shoes with specialized insoles are my bag.

The other thing I noticed is that I went away from overly cushioned shoes and seemed to do better with flat leather shoes for work and negative heel ramped shoes for play. Then lastly, I started stretching about this time. Yoga and resistance stretching including the feet. I routinely splay my toes and lift myself up from say, downward dog or a plank using only my toes to further stretch all of the tendons of the foot.

Good luck to you and I hope yours gets better over time like mine did.

[quattro]

Anyone here an expert on this?? :)

For the past 2-3 weeks I find my 2nd, 3rd and 4th toes on both feet, maybe a little worse on one than the other, have been sore....maybe burning soreness, under the pads. But no pain under ball of foot, and none in big toes or pinky toes.
Not really -strictly- burning and not tingling, not really any discoloration. But sore to touch.

Wondering if Mortons could explain this?

I have, also for the past several years I think had a bit of 'reynauds' (sp?) where if I am on a cold floor my toes can go blue, but this is different, no discolor and always sore.

In good shape, no history of diabetes or MS or ALS etc in family. Active triathlete so my feet do take a bit of a pounding.

Yup, I have a doc appt, but not for about 10 days, takes a bit longer in Canada..

Edit - I should also add that I do struggle with shoe width, both in forefoot and midfoot, and do have orthotics with met pads. I actually have the bunion area cut out of my shimano tri shoes. But the thing that puzzled me about this is that whenever I read about mortons, it always seems to reference pain under ball of foot radiating up to toes, but I don't seem to have that, just mostly the last like centimeter of the 2nd-4th toes.

Cheers

Hey oldguy00, how are you doing? I've had Morton's Neuroma for years, well documented on this forum, LOL! Mine is in my left foot, second and third metatarsal area. I also have nonfat pad under the metatarsals due to cortisone shots in the foot, don't get them! Plus I have hammer toes, all of these things contribute to my issues, so my discomfort is probably different than what you are experiencing. I have tried many things over the years, I have custom orthotics for my everyday shoes, no longer use a metatarsal pad, what I have found is wide fitting shoes of every kind, sneakers, dress, hiking, cycling, etc, are what is needed to take the pressure of the nerves between the metatarsals. As recommended below, Lake cycling shoes have also worked very well for me,I ride the CX241 wide with custom cycling orthotics and can ride comfortably. Your Dr. hopefully will make the correct diagnosis and suggest how to deal with it going forward, you're on the right track. Good luck!

[oldguy00]

Thanks all. Always a bit nerve racking when checking 'Dr Google'...lol

[Veloo]

I have.
Flared up during a tour last summer.
My left foot is a bit messed up from teen years and prone to numbness. Three toes went numb (no pain) during the tour in June and while I'm not numb anymore, I can still feel a sensation on 2 toes today.
If you're in Toronto, I went to the specialist at Yonge and Eg NW corner tower and she basically said "they" don't really know the source of MN but there is a surgical procedure if it's bad. Otherwise she recommended I take it easy on the foot and hopefully it goes away.

https://forums.thepaceline.net/showthread.php?t=241074

[wallymann]

i've been dealing and trying to non-surgically manage mortons in my left foot.

the affected nerve is between the 3rd and 4th, is aggravated when cycling or running stairs -- so its worse during cycling season. burning sensation is quite unpleasant, starting from the pads under those toes radiating into the toes themselves. as i get in better shape (read: more force on pedals) it tends to worsen. when it gets bad-bad it does affect walking/running.


i'm sure to have nice orthotics with a proper metatarsal pad in my cycling shoes.
i've gone up 1/2 size in my cycling shoes so i can add another layer of insole padding under the orthotic.
any pressure that draws the toes together is bad -- cycling shoes with just 2 straps is preferable, if there is a 3rd strap across the toes (like my sidi ergos) i leave it loose all the time.
i've also taken to carefully cutting a hole in my insole just in front of the metatarsal pad directly under the affected nerve to minimize direct pressure.
i try to stretch/massage the affected nerve before a workout/ride, which does seem to help.
if it gets really bad i'll get a targeted cortisone injection.
i'm very sure to have street-shoes with enough width in the forefoot to not compress my forefoot or toes together, often meaning i have to go up 1/2 size and adjust fit with insoles.

there is surgery to cut out the affected nerve, but that leaves you with permanent numbness in part of your foot/toes.

you can also achieve the same non-surgically with a targeted alcohol injection which basically kills the affected nerve.

i'm trying to avoid these.

https://static.wixstatic.com/media/d007d5_e1885d85430f49bdbc13db241f3ead5e~mv2.jpg/v1/fill/w_450,h_450,al_c,lg_1,q_90/d007d5_e1885d85430f49bdbc13db241f3ead5e~mv2.jpg

[oldguy00]

i've been dealing and trying to non-surgically manage mortons in my left foot.

it affects the middle 3 toes and is aggravated when cycling or running stairs -- so its worse during cycling season. burning sensation is quite unpleasant, starting from the pads under those middle toes radiating to the toes themselves. as i get in better shape (read: more force on pedals) it tends to worsen. when it gets bad-bad it does affect walking/running.


i'm sure to have nice orthotics with a proper metatarsal pad in my cycling shoes.
i've gone up 1/2 size in my cycling shoes so i can add another layer of insole padding under the orthotic.
i've also taken to carefully cutting a hole in my insole just in front of the metatarsal pad directly under the affected nerve to minimize direct pressure.
i try to stretch/massage the affected nerve which does help.
if it gets really bad i'll get a targeted cortisone injection.
i'm very sure to have street-shoes with enough width in the forefoot to not compress my footbones together, often meaning i have to go up 1/2 size and adjust fit with insoles.

there is surgery to cut out the affected nerve, but that leaves you with permanent numbness in part of your foot/toes.

you can also achieve the same non-surgically with a targeted alcohol injection which basically kills the affected nerve.

i'm trying to avoid these.

Thanks. You guys would get a good laugh if you saw my collection of off the shelf, and custom, orthotics. And also got custom cycling shoes recently which haven't worked out so well, didn't fit right.
That said, my main purpose for getting orthotics in the past was to help with pain on the outside of my foot, which my podiatrist says is the styloid process....(used to think those were only on the wrists!).

Wallymann - what do you do for stretching and massaging of the nerve?

[54ny77]

i get it on one foot when i'm in a stretch of consistent riding and/or around when i hit 2.5-3 hours on bike (regardless of mileage or terrain, it's more a function of time). and especially when its really hot out.

things i've done:
1) changed to shimano pedals (for its wider platform), which helped a little i think. i used to ride speedplays.

2) use a half size shoe larger than i otherwise would, and leave the affected foot straps fairly loose. this i found helps the most. it's especially important to keep shoe strap closest to ankle as loose as possible, supposedly there's a vein or nerve right there that is the starting point for things going wrong. i use shimano wide shoes.

doing these things have helped a bit. not a lot, but incremental improvements.

while i can live with the pain up to a certain threshold, when/if it gets really bad, i simply have to pull over and take a 10 minute break and massage my foot very firmly. that will typically buy me about 40 or so min. of minimal pain free riding so i can get home.

i've read plenty of stories about custom shoes being a mixed bag, and given how often i'm on the bike for 3+ hours, it's not worth it to me to spend the $$$$ for that kind of shoe. at this time, at least.

[oldguy00]

i get it on one foot when i'm in a stretch of consistent riding and/or around when i hit 2.5-3 hours on bike (regardless of mileage or terrain, it's more a function of time). and especially when its really hot out.

things i've done:
1) changed to shimano pedals (for its wider platform), which helped a little i think. i used to ride speedplays.

2) use a half size shoe larger than i otherwise would, and leave the affected foot straps fairly loose. this i found helps the most. it's especially important to keep shoe strap closest to ankle as loose as possible, supposedly there's a vein or nerve right there that is the starting point for things going wrong. i use shimano wide shoes.

doing these things have helped a bit. not a lot, but incremental improvements.

while i can live with the pain up to a certain threshold, when/if it gets really bad, i simply have to pull over and take a 10 minute break and massage my foot very firmly. that will typically buy me about 40 or so min. of minimal pain free riding so i can get home.

i've read plenty of stories about custom shoes being a mixed bag, and given how often i'm on the bike for 3+ hours, it's not worth it to me to spend the $$$$ for that kind of shoe. at this time, at least.

Thanks. Yeah I'm on speedplay too and notice more than ever my feet wanting to pull to the outside, rocking, and find my toes wanting to 'grab'. The inside of my leg, along the post tib tendon area above the ankle actually starts to get tired.
I've tried Shimano and like the larger platform, but I didn't like the float, even on their 6 degree cleats, compared to what I was used to with speedplay.
So I just took delivery of a pair of Look Keo Carbons, and a set of their 9 degree cleats. Haven't tried them yet, but will soon.

[wallymann]

at podiatrists suggestion...i just grab each of those middle toes and lift up and down and move each one individually thru a wide range of motion in all directions. does seems to limber things up a little and prep the nerve for whatever abuse comes next.

as i sit here i can poke a finger at that nerve to elicit a small jolt into my toes! so the neuroma is still there and will probably always be, but it is manageable and much better than it was in years past.


Wallymann - what do you do for stretching and massaging of the nerve?

[steamer]

Custom, handmade met pads made out of moleskin and not wearing shoes that are too narrow up front solved mine.

[verbs4us]

Not an expert, but living with this kind of foot pain/discomfort for several years. After some research, I found that sometimes an L5 nerve root irritation can masquerade as (classic) Morton's Neuroma. Even without a sciatica-type shooting pain or tingling. Under PT supervision, experimenting now with "flossing," which is gentle stretching, once a day, an an attempt to unimpinge a possible impingement affecting L5. Signs are promising: what was numbness is now tingling, which suggests some nerve recovery. Or psychosomatic effectiveness! If you see a foot doc, they will see a foot problem; if you see a physiatrist, they will take a more system-wide view.

[Hellgate]

I'm going in for surgery in 2 weeks. I'm tired of dealing with this for the past 3 years. I have a total of three shoes I can wear, including my cycling cleats. The Lake CX241s have been a godsend.

[soulspinner]

I'm going in for surgery in 2 weeks. I'm tired of dealing with this for the past 3 years. I have a total of three shoes I can wear, including my cycling cleats. The Lake CX241s have been a godsend.

Good luck and let us know how it comes out...…...

[Hellgate]

Good luck and let us know how it comes out...…...Thanks, I will. My Dr and I discussed the options, pros and cons, and surgery seems to make the most sense.

His technique involves embedding the cut nerve into adjacent muscle to prevent scar tissue from reforming. He claims it's 100% effective. Otherwise we keep chasing it with injections which, to me, is not an effective course of action due to fat pad loss.

[Hellgate]

Day one, post op. Nerve block is in high gear still. [emoji4]

The Dr said the neuroma he removed was, "huge." And this is from a guy who has removed them each week for decades. https://uploads.tapatalk-cdn.com/20200207/07b7f3beba03a6645734f4f254ef04ed.jpg

[soulspinner]

:hello:

[Hellgate]

My foot fits in my cleats, Sidis and Lakes. Mellow flat ride tomorrow. 20 miles? Maybe.

I'm off crutches at the house. On them at work only as a warning signal to others if that makes sense?

My foot looks like two pieces of beef jerky sewn together. Photo if you like...ick.

Oh, and cryo is a godsend, better than any drug.

I took a total of 6 Oxy to taper off the nerve block. No dope since last Friday night. "Can of corn."

I'm still doing two, 2 cryo sessions a day to promote healing.

The third and fourth toes are dead numb, however, I can move them with no issues. After a few weeks I assume I won't notice. It beats the hell out of stepping on a Lego with each strike of the foot!

[soulspinner]

My foot fits in my cleats, Sidis and Lakes. Mellow flat ride tomorrow. 20 miles? Maybe.

I'm off crutches at the house. On them at work only as a warning signal to others if that makes sense?

My foot looks like two pieces of beef jerky sewn together. Photo if you like...ick.

Oh, and cryo is a godsend, better than any drug.

I took a total of 6 Oxy to taper off the nerve block. No dope since last Friday night. "Can of corn."

I'm still doing two, 2 cryo sessions a day to promote healing.

The third and fourth toes are dead numb, however, I can move them with no issues. After a few weeks I assume I won't notice. It beats the hell out of stepping on a Lego with each strike of the foot!

Good for you!

[Tickdoc]

Glad to hear you are healing well and out of pain!

[54ny77]

Congrats!

Can you expand on the cryo therapy treatment? What's it like?

Day one, post op. Nerve block is in high gear still. [emoji4]

The Dr said the neuroma he removed was, "huge." And this is from a guy who has removed them each week for decades. https://uploads.tapatalk-cdn.com/20200207/07b7f3beba03a6645734f4f254ef04ed.jpg

[Hellgate]

Congrats!



Can you expand on the cryo therapy treatment? What's it like?Sure, cyro is cold water treatment. The device is a cooler with a fish tank pump that flows chilled water through a pad. The pad is wrapped around the area to treat. It's left on for 2 hours, then off for an hour.

I've used it for this injury, an ACL repair, and a shoulder reconstruction. It kills pain and reduces inflammation better than any drugs.

During my ACL recovery, at 2AM, I counted the number of Oxy or Norco pills I'd taken over the past 24 hours. The count was 17! (I'd had 5 holes drilled in bone and pain was unreal) I had my wife rent a cryo unit the next morning at 8AM. Within 5 minutes of application the pain was gone.

This particular unit is the collective property of my cul-de-sac. It has been used by 5 different people! Primarily 4 women recovering from bunion surgery.

I can't recommend one enough.

Tonight's treatment.

https://uploads.tapatalk-cdn.com/20200216/2a495505d32d211d965ab6e3d7babf72.jpghttps://uploads.tapatalk-cdn.com/20200216/8d936e6486dac0ae63615c0a7d7cbc96.jpg

[54ny77]

Thanks a ton for that info and good luck on your full recovery. :cool:

[LouDeeter]

I had surgery 25 years ago. Nerve that was removed was like a piece of spaghetti on each end and about the size of my thumb in the middle. Numbness isn't a problem. I wore combat boots and cycling shoes for years before the surgery. Not wearing combat boots wasn't an option, thus the surgery. I had used metatarsal pads for a few years before that. Best advice for just cycling is to loosen your shoes at the first sign of the "fire foot".

[Hellgate]

Rode 20 today, 10 days post surgery. Zero pain at all. Stood up and sprinted up to 28, powered up hills, felt great! Tomorrow will be another 20. From what I've read, people are running 3 to 4 weeks post surgery.

Interestingly, the best my foot has felt, post surgery, is in my Lake 241's. Instead of the flat Velcro shoe, a proper, positioned shoe with a rocker sole would work better.

[CSTRider]

63 year old lifelong cyclist/runner here, and have had Morton’s excision surgery on both feet at different times. Right foot was done in ‘95 after injections, orthotics, icing, etc. Finally got to the point where I couldn’t walk for more than about 50 minutes or run about 1.5 miles before feeling like my foot was on fire. Was active duty army, so had to get it fixed. Doc pulled out a 2 cm bundle and asked whether I had any symptoms in my right foot. When I told him I didn’t, he replied “don’t be surprised if you do in the future”.

Sure enough, in 2014 had to get the right foot done after developing similar issues. Different Doc pulled out a 2.5 cm bundle – said it was one of the biggest he’d seen. Was on bike trainer in about a week and running/snowboarding in a month, but had intermittent foot swelling (treated with icing) which I didn’t have after first surgery. Back to cycling about 4000+ miles and trail running about 400 miles annually with no pain in either foot. In my experience, stiff, wide carbon soled cycling shoes (like Lake CX237 wide) and running shoes with enough forefoot volume to spread toes are key.

[Hellgate]

Rode 45 yesterday. Foot felt "ok." Rest and ice was needed at the end of the ride.

The doctor says I have another 2 to 3 months to go. The current healing is very deep in the foot. Overall, very good recovery. The two numb toes are odd at best. That said, I'm still glad I did this as my 6 YO and I played tag today. The first time in 4 years.

Big difference, huh? Week 1 vs week 6. https://uploads.tapatalk-cdn.com/20200319/e0789da20a587cdb9eb49d1f51863385.jpghttps://uploads.tapatalk-cdn.com/20200319/747ab5bb5fad3c72760baf892171c27c.jpg

[flying]

In Jan 2019 I bought a new set of Northwave shoes

Maybe more narrow than usual but I never had a problem with narrow before.

Fast forward to Sept 2019 & I realize I have a major metatarsal problem in right foot

Whether or not it became morton's I don't know but I do know switching to wider shoes & this video made a BIG difference.

https://www.youtube.com/watch?v=5UmS3vFBVs0&feature=emb_logo

[Rpoole8537]

Day one, post op. Nerve block is in high gear still. [emoji4]

The Dr said the neuroma he removed was, "huge." And this is from a guy who has removed them each week for decades. https://uploads.tapatalk-cdn.com/20200207/07b7f3beba03a6645734f4f254ef04ed.jpg

I like the 100% effective part. Is this a technique known by other doctors? I had alcohol injections and they actually helped a great deal. I’m now experiencing neuropathy, which is not a good thing, but my neuroma hurts much less now! Choose your poison???
Hiking gives me more issues than cycling. I’ve had to stop and soak my feet in a cold stream in order to get back to the car. Very painful experience.

[Hellgate]

Week 9.

I'm almost back to "normal." Ask my 2 ex-wives about that...

Normal in that I am noticing my foot much less. Pins and needles, throbbing are several weeks behind me. I'm not favoring my right foot, leg. It doesn't wake me up in the middle of the night. And, I ran with my daughter about 100m!

The bad? From elevating my leg so much I've strained/ pulled the nerve that runs about the outside of the ankle bone. Freaking sharp pain when I rotate my foot to the inside. I've had the condition for about 2 weeks.

The good? I've comfortably worn shoes I've not worn in 9 months.

So far, so good. I just need the ankle nerve to mellow a bit.

Oh, cycling has been great. My fitness needs some work, but it's coming back. [emoji4]

[Hellgate]

Well, as of tonight I'm out of my orthopedic Lakes and back in my Sidi Wires, albeit for an easy 45 minute ride. The foot felt very good. I need to leave the forefoot loose. Too tight and I can get an odd full, pressure feeling at the point of surgery.

With C19 I've only worn flip-flops, the Lakes, and a pair of On running shoes. Some day I'll buy a proper pair of new dress shoes.

Overall I'm still happy with the results and figure I have another 4 months of healing in front of me.

[soulspinner]

Cool. Nice to know there is hope....

[djg21]

Thanks. You guys would get a good laugh if you saw my collection of off the shelf, and custom, orthotics. And also got custom cycling shoes recently which haven't worked out so well, didn't fit right.
That said, my main purpose for getting orthotics in the past was to help with pain on the outside of my foot, which my podiatrist says is the styloid process....(used to think those were only on the wrists!).

Wallymann - what do you do for stretching and massaging of the nerve?

What custom cycling shoes did you go with?

[djg21]

Thanks. Yeah I'm on speedplay too and notice more than ever my feet wanting to pull to the outside, rocking, and find my toes wanting to 'grab'. The inside of my leg, along the post tib tendon area above the ankle actually starts to get tired.
I've tried Shimano and like the larger platform, but I didn't like the float, even on their 6 degree cleats, compared to what I was used to with speedplay.
So I just took delivery of a pair of Look Keo Carbons, and a set of their 9 degree cleats. Haven't tried them yet, but will soon.

If you were using Speedplay X pedals, the cleat retention clips tend to wear on the outside and develop flat spots. This would cause some up and down play and would make it feel like you were pedaling on the outside edge of the pedal. The Zeros were an improvement as they had flat clips.

I’ve had a Morton’s issue develop from wearing work/dress shoes that were too narrow. I learned my lesson and now purchase only good shoes that are wide enough to accommodate my feet. The problem is that once you have Morton’s, it doesn’t ever fully go away. I still get pins and needles in my toes in the evening, but it’s isn’t get worse. I use Lamson Cycling Shoes, and I’ve used Don’s shoes for years. His insoles certainly help (I use the in all of my casual shoes and in my telemark ski boots), and having cycling shoes that he built to fit my feet certainly helps.

[srider]

I've had a neuroma in both feet for several years, like others it was caused by wearing too restrictive shoes (super tight rock climbing shoes when I was younger..).

Going to a wider toe box shoe like Lake is a good idea, and I've recently picked up a couple pairs of Shimano's wide shoes too that are equally comfortable.

IMHO, wider shoes, met pads, orthotics, etc all help, but wearing toe spacers like Correct Toes or Yoga Toes as much as possible has been far more beneficial. Over time they help realign and spread the metatarsals so that the neuroma no longer being compressed or irritated.

By wearing Yoga Toes when off the bike, and wide shoes when I'm riding, I've (knock on wood) been able to avoid surgery and almost completely eliminate the neuroma pain/numbness/etc.

Hope this helps and good luck!

[XXtwindad]

Week 9.

I'm almost back to "normal." Ask my 2 ex-wives about that...

Normal in that I am noticing my foot much less. Pins and needles, throbbing are several weeks behind me. I'm not favoring my right foot, leg. It doesn't wake me up in the middle of the night. And, I ran with my daughter about 100m!

The bad? From elevating my leg so much I've strained/ pulled the nerve that runs about the outside of the ankle bone. Freaking sharp pain when I rotate my foot to the inside. I've had the condition for about 2 weeks.

The good? I've comfortably worn shoes I've not worn in 9 months.

So far, so good. I just need the ankle nerve to mellow a bit.

Oh, cycling has been great. My fitness needs some work, but it's coming back. [emoji4]

Glad you're on the mend, Pete. I was going to ask what the factors were that contributed to the MN, but maybe srider (below) answered it. Do you know how this differs from Plantar Fascitis? I've dealt with that over the years (primarily due to flat feet) and stretching my calves (gastroc and soleus muscles) out daily helps tremendously.

[Hellgate]

Josh I'm not experienced PF, is sounds terrible, and similar pain wise to a MN.

From the reading on WebMD it sounds like and age and activity related injury.

Have you seen a doctor about it?

[XXtwindad]

Josh I'm not experienced PF, is sounds terrible, and similar pain wise to a MN.

From the reading on WebMD it sounds like and age and activity related injury.

Have you seen a doctor about it?

My partner’s cousin is a podiatrist. Several years ago (at a family event) I showed him my feet and the first thing he asked was “what happened to your arches?”

I had it really bad about a year ago. It was caused by wearing shoes with not enough support and cranking up the resistance on the exercise bike. Stretching my calves (which tend to be really tight) helped a lot.

Also: resistance exercises for the small muscles in the feet, such as balancing on one foot. I started mixing in more walking with the cycling, and that helped, too.

[John H.]

I have had neuromas removed from both of my feet. They also removed cysts that had developed in that area an re-shaped the sesamoid bones.
It worked great on my right foot- but the issues returned on my left foot.

I have always been an orthotics wearer and in that period I tried all types of shoes including custom- none fixed my issue.

As a hail mary after the 2nd surgery on my left foot, I tried an old pair of Bont shoes that I had lying around. They totally fixed the issue.
I believe it was a combination of the width and toe box shape, but also the stiffness, bathtub shape and how well that the Bont shoe holds the orthotics.

[TimAZ]

I've had a neuroma in both feet for several years, like others it was caused by wearing too restrictive shoes (super tight rock climbing shoes when I was younger..).

Going to a wider toe box shoe like Lake is a good idea, and I've recently picked up a couple pairs of Shimano's wide shoes too that are equally comfortable.

IMHO, wider shoes, met pads, orthotics, etc all help, but wearing toe spacers like Correct Toes or Yoga Toes as much as possible has been far more beneficial. Over time they help realign and spread the metatarsals so that the neuroma no longer being compressed or irritated.

By wearing Yoga Toes when off the bike, and wide shoes when I'm riding, I've (knock on wood) been able to avoid surgery and almost completely eliminate the neuroma pain/numbness/etc.

Hope this helps and good luck!

Yoga Toes have been purchased. I've been wondering about these. Thanks for the nod.

Tim

[Flying Pigeon]

Funny for me it was another thread on PL from 2019 (https://forums.thepaceline.net/showthread.php?t=241074) that was my education right when I picked up Morton's Neuroma. :banana: (I'm blaming a couple weeks of sleeping in full length compression socks, and maybe tight socks all day in running shoes). If only I could go back and tell myself never compress my feet. I think toe socks are great for keeping a natural splay but it's way too late for that now.

Foam spreaders are the salvation for me -- cheap drugstore specials, 2 of them between my smallest toes. Done that for almost 2 yrs now. I notice if they slip out because the tingly pain returns. I can't really go barefoot because it's too much for my metatarsals, nor can I do extra jarring things like running downhill on pavement. But otherwise have been able to manage it with the spreaders 24/7. Luckily wide Shimano RX8 shoes are fine all day, while climbing shoes seem like a never.

Anyone who investigates this procedure with ultrasound + alcohol injection please report back.

[Sktr62]

Funny for me it was another thread on PL from 2019 (https://forums.thepaceline.net/showthread.php?t=241074) that was my education right when I picked up Morton's Neuroma. :banana: (I'm blaming a couple weeks of sleeping in full length compression socks, and maybe tight socks all day in running shoes). If only I could go back and tell myself never compress my feet. I think toe socks are great for keeping a natural splay but it's way too late for that now.

Foam spreaders are the salvation for me -- cheap drugstore specials, 2 of them between my smallest toes. Done that for almost 2 yrs now. I notice if they slip out because the tingly pain returns. I can't really go barefoot because it's too much for my metatarsals, nor can I do extra jarring things like running downhill on pavement. But otherwise have been able to manage it with the spreaders 24/7. Luckily wide Shimano RX8 shoes are fine all day, while climbing shoes seem like a never.

Anyone who investigates this procedure with ultrasound + alcohol injection please report back.

Had alcohol injections in both feet. Plus cortisone shots. Helped initially but then Right foot is still chronic. MN is my nemesis. Just comes and goes, stretching, massaging w/tennis balls, etc seems to help. NSADs & 8hr Tylenol help when it's really bad. My symptoms range from Plantar Fasciitis in forefoot, metarsalgia, MN, mystery scar tissue. I have foot length issues, developing hammer toes, so my overall state is most likely due to decades of wrong size shoes. My MN are very deep, 2-3, and very hard to image. I mostly just try to ignore them. And I avoid cycling on hot days.

[mcteague]

My podiatrist has suggested ligament release in lieu of total excising of the nerve. This seems to be the way forward for many people. While still surgery, it is far less extreme than having the nerve cluster cut out.

All the more basic stuff (cortisone, orthotics, etc) have done nothing for me. Still have not decided on having it done but am leaning in that direction.

https://advances.massgeneral.org/ortho/journal.aspx?id=1811

Tim