Burning or Cramping Toes…You’re Getting On My Nerves
A common statement from a mother to her child, especially if the child is a teenager, “you’re getting on my nerves!” Although commonly used this statement is factually incorrect. Those of us who have studied anatomy and physiology know that unless the teenager in question is into torture techniques it is very difficult to get ‘ON’ someone’s nerve.
There is however a very common malady that, if you have it, resembles medieval torture. It is called Morton’s Neuroma. The word neuroma means ‘nerve tumor’. In this case it is strictly a benign thickening of the myelin lining of the nerve.
Quick anatomy lesson: A nerve is similar to an electrical wire. It has a central core through which an electrical impulse can pass and a fatty (myelin) lining that functions like the rubber insulation on the wire.
There is a ligament that goes across the ball of the foot that helps hold the bones together. The nerves that innervate the bottom of the toes actually go under this ligament and then up into the toes. A knowledgeable electrician would not have laid out the wiring this way.
As this weight-bearing ligament rubs on the nerve, it will protect itself by building up more of the insulating lining. So essentially a neuroma is all normal tissue, just too much of it. As the myelin lining builds up it compresses the central core of the nerve and resembles medieval torture. If you can picture it, the enlarged nerve sits between the bones of the ball of the foot, under the ligament. As a result the two motions that aggravate it the most are: 1. Anything that squeezes the bones together, like a tight shoe, and anything that presses the toes upward, pulling the nerve tighter against the ligament.
Typical symptoms of neuroma include: numbness and tingling cramping of toes, and sharp shooting pain that radiates up the foot and leg.
Treatments include: padding and orthotics to take the pressure off the nerve, injections, and possible surgical removal of the neuroma.
Now that we have solved the burning and cramping in your foot let’s get back to our troubled teenager. If he continues to bother his mother she might upgrade to, “You are getting on every inch of my nerves!”
OK math majors lets analyze this. There are 12 inches to a foot, 5,280 foot to a mile, estimated 45 miles of nerve tissue to the human body. That makes 2,851,200 inches of the nerve. Impressive but it is not advisable to bring this to the attention of the mother who just made the statement unless you are ready to duck the blunt object she is about to throw at you.
One should never tug on Superman’s cape, spit into the wind, pull the mask off the ol’ lone ranger, or criticize the words of wisdom in that great Mom’s Handbook. Other Gems include:
Clean your plate (finish your food) for those starving kids in China.”
“Don’t cross your eyes. They may get stuck there.”
“Don’t run with that you may poke your eye out.” Point of order your honor. You can poke your eye in but it is pretty hard to poke your eye OUT.”
“If your friends jumped off a bridge would you do it?” This pre-dated bunji jumping.
“Don’t play with your belly button. You could break it and fly around the room backward like a balloon.” I have to say this one had me carrying an industrial strength ‘knee’ size bandage until I was 28. Sorry Mom.
Dr. Dennis Chubinski
Waynedale Foot Clinic
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