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Ask the Sports Doc: Numbness

EY asks: My right foot has been going numb for the past few months. I used to bowl a lot and now I can’t even put the shoes on without it hurting. My second and third toes burn all the time.

My family doctor did do some X-rays but she said they were normal. I have not seen a specialist yet and was wondering what I should do.

Dr. Patel writes: Dear EY, you may have one of two different things going on with your foot. Even though your X-rays were negative, there are other studies that can help determine the cause of your pain.

One of the first things to rule out for you is a potential stress fracture. A stress fracture can occur at any age and may not show up on plain films early on.

The two main studies that are useful are an MRI or a bone scan. A bone scan is a nuclear medicine study that can potentially be useful to diagnose a stress fracture or even an infection of the bone. I like MRI’s because it can rule out a stress fracture as well as give good detail on the soft tissues as well. MRI’s can also help diagnose a neuroma as well.

A Morton’s neuroma is a fibrotic nerve that is inflamed and potentially scarred around some soft tissue. It can present with burning and numbness between the second and third toes.

Treatment options for a stress fracture most likely would include a cast or some type of immobilization. If you have a Morton’s neuroma, sometimes a cortisone injection can help. If the injection does not provide relief and the MRI is positive for a neuroma, then excision of that may help.