Physio webchat with Paul Hobrough

Catch up on our webchat for expert advise from Paul Hobrough.

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Q. I've been having a niggling pain in one of my toes for a number of weeks, which became really bad during a 16km run. I continued through the run (the pain subsided after 20 mins) and then took 10 days off running. I've been trying to start up again, but I still get a sharp pain sometimes in the end of my toe when I run. I discovered that when I press on one specific area of the ball of my foot, I feel the pain at the end of my toe. I think this could be some nerve damage perhaps? Do you have any suggestions for recovery? I've tried a week of taking ibuprofen to reduce any swelling, but I can still sense it there in the background. I was running with specially made inserts at the time it happened (I had them fitted about 8 weeks ago). - Sarah Fencott

A. There is every chance you have a nerve issue, I would like to know if this pressure point you describe in the ball of your foot is between the 2nd and 3rd Toe or the 3rd and 4th toes? If so then you may well have a morons neuroma or "Morton's metatarsalgia" so as not to confuse the term with more serious conditions associated with a neuroma. Think of it as a bundle of swollen tissue around your nerve which causes symptoms with pressed (e.g. running/walking). You can try squeezing your toes together and see if you can feel or hear a little click between the toes, this will give further evidence to the fact that this might be the case. In order to help….  orthotic devices have been known to have some benefit, although in many cases surgery is the best option, albeit not always totally successful. In the mean time, try not to wear shoes that are tight fitting, use anti inflammatory medications, rest and look for some of the gel inserts that you can use to reduce impact on the area. Anything that squeezes the metatarsal heads together will make your symptoms worse.  Caveat: I still don't now the answers to your initial questions so I may be totally wrong about this possible diagnosis.

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