Dear Dr. Garner,

I have the most painful problem with my feet.

I love to wear high heels, particularly brands like Manolo Blahnik and Christian Louboutin. I think I am being punished for spending so much money on shoes. The pain is unbearable. I feel sparks, numbness and tingling.  The pain is relieved as soon as I take my shoes off.

Even wearing sneakers does not help much. Am I doomed to have this problem for the rest of my life?
Cursed by Love of Louboutin in Laurelton

Dear Cursed,

Thank you for writing in.

I was talking with my good friend and noted podiatrist Dr. Pat Grisafi. Your symptoms describe very accurately the condition known as Morton’s neuroma. It usually affects the ball of the foot, most commonly the area between the third and fourth toes.  It is hard to feel from the outside, but one definitely knows it is there.  People describe the situation as though they were standing on a rock. The burning and numbness can be exasperating.
The neuroma is a thickening or enlargement of the nerves in the foot. No one knows exactly what causes the Morton’s neuroma. It is an irritation or inflammation that causes the nerves to malfunction.  Wearing high heels, jogging, or running can be the culprit. Skiing can also cause this problem. People who have bunions are predisposed to developing the neuroma.

There are tests that are very helpful in determining if one has the condition. MRI can demonstrate the neuroma very well. In addition, sonograms can help to spotlight the area and extent of the problem.

Your doctor may order an X-ray to see if there is evidence of fractures, or other deformities of the feet that might mimic the pain of a neuroma.

There are treatments that will bring you relief. Your doctor may devise arch supports and orthotics to fit in your shoe and reduce pressure on the nerve. Sometimes doctors will inject cortisone into the area to reduce the inflammation and pain. Others use alcohol injections. This may take several injections. Sometimes, it is necessary to remove the nerve entirely by surgery.

There are some things you can do at home to help:
• Drugs like Motrin and Aleve are very helpful in reducing pain and swelling.
• Ice massage may reduce pain. You can do this by freezing a plastic cup filled with water and rubbing it on the area.
• Give your feet time to heal by resting them for a few weeks.
• Finally, the advice I’m sure your dreading most — stop wearing high heels. Get a shoe that is not so narrow to give your toes the ability to spread out.

I am sure that with the help of your podiatrist you can arrive at a good plan of action, which, just maybe, can include the occasional use of your beloved shoes.

Please keep me informed of your progress.

Until next week, be well.[hr] Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET, Tuesdays at 8 p.m. on Ch. 97 Time Warner and Ch. 30 Cablevision.