Explanation of Diagnosis

Morton’s neuroma is a thickening of the tissue around the nerves leading to the toes, most commonly between the third and fourth toes. It is caused by compression or irritation of the nerve, often due to tight shoes, high-impact activities, or abnormal foot mechanics. Symptoms include burning pain, numbness, tingling, or the sensation of a “pebble” in the shoe.

Specific Work Modifications

• Avoid prolonged standing or walking on hard surfaces.
• Wear wide, cushioned shoes with a soft toe box to reduce nerve compression.
• Use orthotic inserts or metatarsal pads to relieve pressure on the nerve.
• Take sitting breaks if the job requires extended walking or standing.
• Avoid tight, narrow, or high-heeled shoes, which can worsen symptoms.

Specific Activity Modifications

• Avoid high-impact activities such as running, jumping, or sports requiring tight footwear.
• Modify workouts by switching to low-impact exercises such as cycling, swimming, or elliptical training.
• Use shock-absorbing insoles if engaging in sports or walking long distances.
• Avoid barefoot walking, especially on hard floors.

Recommended Supplements

• Vitamin B6 (50-100 mg daily) – Supports nerve health.
• Alpha-lipoic acid (600 mg daily) – May help with nerve regeneration.
• Magnesium (300-400 mg daily) – Aids in muscle relaxation and nerve function.
• Omega-3 fatty acids (1000 mg daily) – Reduces nerve inflammation.
• Turmeric (500 mg twice daily) – Provides anti-inflammatory benefits.

Recommended Nutrition and Hydration

Diet Recommendations:

• Anti-inflammatory foods: Fatty fish (salmon, sardines), turmeric, berries, nuts, and leafy greens.
• Nerve-supporting foods: Avocados, eggs, dark chocolate, almonds, and whole grains (rich in B vitamins).
• Limit processed foods and excessive sugar, which can worsen inflammation.

Hydration Tips:

• Drink at least 2–3 liters of water daily to maintain nerve function.
• Limit caffeine and alcohol, which can dehydrate tissues and slow healing.

Home Exercise Prescription

Perform 2-3 times daily to relieve nerve compression and improve foot strength:

1. Toe Spread & Splay Exercise

1. • Place your foot flat on the ground and try to spread your toes apart.
   • Hold for 5 seconds, repeat 10 reps per foot.

2. Metatarsal Doming (Arch Strengthening)

1. • Try to lift the arch of your foot without curling your toes.
   • Hold for 5 seconds, repeat 10 reps per foot.

3. Rolling Massage with a Ball

1. • Use a tennis ball or frozen water bottle under the foot and roll it gently back and forth.
   • 1-2 minutes per foot, 1-2 times daily.

4. Calf Stretch (Straight & Bent Knee)

1. • Stand facing a wall, place one foot back, and keep the heel on the ground.
   • Hold for 20-30 seconds, repeat 3 times per leg.

5. Towel Scrunches (Toe Strengthening)

1. • Place a towel under your foot and use your toes to scrunch it toward you.
   • 10 reps, 2 times daily.

Avoid tight shoes, high-impact activities, and excessive foot pressure until symptoms improve.

Helpful Books

1. "Fixing Your Feet: Injury Prevention and Treatment for Athletes" – John Vonhof
2. "Every Woman’s Guide to Foot Pain Relief: The New Science of Healthy Feet" – Katy Bowman

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.