Question
Dr Katz,
I have tingling, phantom sensations, sharp hot burning pain, in my feet. Its
also sometimes achy especially when I try and where a dress shoe. If I wear
sneakers and my orthotics I can get around, but cannot run. I was extremely
active and my pain came on when I was ski patrolling, cycling 30-40hrs per
week, and weight lifting (squats, leg press, etc. etc.). when the Pain began I
was not wearing orthotics...I never used to need them. I had achilles
tendonitis during my growing yrs, but other than that no foot pain. Ive always
had very high arches w/thin lower limbs. When I was cycling I was able to
build up a good amt of muscle on my legs, but now they are back to being
very thin. Most Dr's that I see immediately think CMT but I had all that testing  
which was all normal. My foot pain gets better if I wear wide cushiony
sneakers, loosely tied, however as soon as I try and run, wear dress shoes,
cycle, ski, or anything other than walking (which hurts sometims) my feet
hurt...Its an achy feeling with tingly/phantom sensations. My right foot is the
worst. When the pain began it started in my right foot, but I think because I
was favoring my Rt it started up in my left.
I received injections for possible neuromas. Im not sure that they have done
much to help. I get maybe a day or two with less pain. Is it possible to have
multiple neuromas in one foot? I should also note that my ski boots were
usually 3 sizes too small and my cycling shoes were about 2 sizes too small. I
wanted them to be super tight. Usually my feet went completely numb while I
was doing those activities.
I have been going to Brigham and Womens and I have a potential diagnosis
for Ankylosing Spondolytis. I do have heel pain and plantar F pain, but those
are managable...its the nerve type pain that is really difficult for me to deal
with.
Would this be something I could try Cryosurgery for? If so is there anyone in
the Mass, NH, Maine area that you could recommend.
Thanks for time.
Patrick

Answer
Hi Patrick,


You have likely done damage to your foot buy allowing them to be compressed for long periods and allowing them to go numb.  The numbness was a sign to you that something was not right. It is highly unusual to have multiple neuromas, however this sounds more like a type of neuropathy.

Cryosurgery would certainly be a good option as long as you have a diagnois.  However, there are a fair amount of people with neuropathy without a cause.

I personally do not know anyone that does cryosurgery in the areas noted above.  If you do have cryosurgery make sure you see someone that has experience treating more unusual types of problems.  Technique is everything.

Also, consider seeing a neurologist if you haven't and explore the option of a spinal cord stimulator which is commonly placed by a pain management specialist.


Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com


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