This causes discomfort and misery, but it is very difficult to put your finger on it!
Typically, it does not hurt all of the time, it is usually when you are wearing shoes, and on your feet for a time. For me, it starts when I am out walking, at about the 5 miles stage. It feels like a lump in my foot, just back from my 3rd and 4th toes. It can ‘fizz’, or ache, or feel sore. I can’t find it when I press on my foot. It is irritated my tighter fitting shoes or even tight socks. I find that I am limiting my activities to avoid discomfort, which makes me feel low. It slowly becomes more of a problem.
It is an enlargement of the nerve in the foot which is irritated and becomes inflamed.
Why does it Develop?
It is associated with one of the following or a combination of:
- wide, mobile feet
- a bunion, or a foot which is developing one
- a hammer toe/toes
For me it is 3 of the above!
How is it Diagnosed?
The clinical test is called a Mulder’s click, where we gently squeeze the foot and press down with our thumb, and a ‘click’ is felt where the nerve moves in the foot. At Total Foot Health we also have diagnostic ultrasound which allows us to see it inside the foot.
How do we treat it?
A steroid injection is the current initial approach, if conservative measures have not helped. Steroids reduce inflammation and cause softening effect on soft tissue, which is exactly what you want. At Total Foot Health we use ultrasound guided injections, which ensures that the steroid goes exactly where we want it to! If this is beneficial, further injections can be arranged. If this is not effective, we would refer on for a surgical opinion regarding surgical excision of the thickened nerve.
