I Feel Like I am Stepping on a Pebble Inside My Shoe

The tale of the phantom pebble. There might really be an object in your shoe, especially if there are kids in the house, but this is not about that. It’s where you’re plagued by an uncomfortable sensation in the forefoot, and it can happen to people from all walks of life, pun intended. 

Sometimes, it’s even painful, but when you look, there’s nothing there. 

The real problem is around one of the nerves in your foot. It’s known as a neuroma. It’s typically not visible, but the feeling is very real. It feels like you’re stepping on a lump.

The body grows tissue around an injured or inflamed nerve in an attempt to protect the nerve. This effort can result in problems in itself because the tissue buildup causes the nerve to become pinched or compressed. A forefoot neuroma is also known as a “Morton’s neuroma.” 

Symptoms of Morton’s neuroma 

This condition can have varying symptoms. There is sometimes visible swelling between the toes or tingling and numbness. Apart from the feeling of stepping on a pebble in your shoe, there can be a burning sensation between the toes or near the front of the foot. When you shift your weight to that foot, it gets worse. 

Of course, you probably won’t have all of these symptoms, but even one can be sufficient to diagnose neuroma. 

Causes of neuroma

Neuroma needs some kind of pressure or irritation to build up. There can be any number of causes, including some you can control and others you can’t.

The risk increases from repetitive physical activity, like running and other sports. Of course, that doesn’t mean you shouldn’t do any sports at all. Overall, the benefits of doing sport are more than the risks, and if you take proper care of your feet, this will reduce the risk of neuroma a great deal. Appropriate measures include exerting only moderate pressure on feet and wearing supportive shoes and insoles for your activities. Never push yourself beyond what you feel you’re capable of. 

About shoes

Even if you don’t do sport, the right shoes are essential. They should provide adequate support and not exert pressure on the forefoot. Neuroma risk increases with certain types of shoes, such as high heels. The back end is high, pushing the weight toward the forefoot. What’s more, high heels usually have small toe boxes. These cram the toes together and force weight down on them.

This pressure creates prime conditions for neuromas to form. Your choice of shoes is definitely a factor you can control. There are also some that you can’t. Foot shape deformities and abnormalities are among them. This makes your choice of shoes and insoles even more vital.

Flat feet and high arches

Deformities and anomalies in foot shape can cause the body to shift weight toward the front of the foot. Flat feet or high arches can shift weight distribution across the foot, which creates a higher risk for neuromas and other health issues.

Direct nerve injury can cause the development of a neuroma, as mentioned. This can include dropping something on your foot or tripping and falling.

To treat neuroma, it must be diagnosed first. Many different conditions can imitate the sensation it causes. If your foot pain continues for more than a few days, you need to make an appointment with a specialist. Unless you take measures to address the causes, the neuroma probably won’t go away on its own. Trying to cope with the pain as best you can is not a solution. It will only make the neuroma last longer or become more painful.

Diagnosing neuroma 

A specialist will examine you to find the cause of the irritation. This will involve looking for tender spots by pressing down on your foot. A symptom of Morton’s neuroma can also be a clicking sound coming from between the toes. 

The doctor will ask when the pain started, what you do, how active you are, and what kind of shoes you wear most often. They will perform a test to check your range of motion. Conditions like joint inflammation and arthritis can cause nerve pain too, so they will move your foot to rule these out. 

More likely than not, they will order additional tests and exams, like an X-ray, an MRI, or an ultrasound. An X-ray can help rule out other issues. 

Ultrasound exams create images using sound waves. They are a good way to diagnose soft tissue conditions, including Morton’s. 

MRI, or magnetic resonance imaging, uses magnetic fields and radio waves to examine soft tissue. However, it is rarely applied to diagnose Morton’s neuroma because it’s expensive, and there are more affordable ways to check for this condition. 

Treatment of neuroma 

In most cases, a neuroma will go away on its own as long as you take measures to eradicate the source of irritation. These might include custom orthotics, arch supports, wearing a different type of shoe, or changing your physical activity regimen. Custom orthotics are tailored shoe inserts that can minimize the pain caused by neuroma by removing pressure from the inflamed or injured nerve. 

These inserts keep the metatarsal bone from dropping and provide support to your forefoot. They alleviate the pain and tingling feeling associated with a neuroma. 

People who wear flat shoes can also develop Morton’s neuroma. In this case, custom orthotics can help as well. No matter what your favorite shoes are – sneakers, boots, heels, etc. – the built-in support of the inserts will lift the bone structure and reduce the friction and excess pressure on the metatarsal bones. There will also be relief in the ligament and the nerves around it.

Custom orthotics are simple, discrete products that can provide lasting, effective relief from the discomfort and pain associated with a neuroma. They simply slide into your closed-toe shoes.

They can even prevent other health problems and injuries that poorly fitting shoes can cause, like sore knees and back problems. 

Mobility on Mainway offers a wide variety of products to make sure clients can choose the most suitable insoles for their needs. Our products provide lasting relief from pain and discomfort, giving a reprieve from the limitations of the neuroma.  

Neuroma prevention

You can keep neuroma at bay with a few simple precautions, such as avoiding tight shoes or high heels for long periods and wearing only shoes with a wide toe box. 

When you do sport, wear athletic shoes and socks with sufficient padding in the soles to cushion your feet. 

Doctors might also recommend inserting an insole into your shoe to correct any disbalance which could be causing your condition. In addition, there are exercises you can do to help make the foot stronger. 


Contact Mobility on Mainway

If you would like to talk to a specialist to determine if you have Morton’s Neuroma, contact Mobility on Mainway by filling out the contact form below or calling us to speak with our team.

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