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Joplin's Neuritis

Discussion in 'Ask your questions here' started by Rjalal, Nov 9, 2012.

  1. Rjalal

    Rjalal New Member

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    About 6 months ago I developed radiating pain in the ball of my foot, which I self-diagnosed as metatarsalgia. I decided to rest my foot for a couple weeks, and the pain came and went periodically. As the pain decreased, I could start pinpointing where it was coming from, the medial plantar surface of the hallux. At times I would have tingly and numbness in the hallux, and it would be irritated when I walked especially at the toe-off propulsion stage of gait.

    I had x-rays done that ruled out arthritis, osteoarthritis, gout, and stress fractures. I had blood tests done to rule out rheumatoid arthritis.

    I went back to my GP many times because the pain had not resolved, and he decided to send me to a bone scan. The bone scan was relatively normal, just indicated an increase of bone activity at the 1st MPJ, maybe from my limping.

    On October 19th, I had an MRI done because there was still no diagnosis. The MRI did not show anything significant. My Doctor suggested to me that the most likely source of pain is something called Joplins Neuroma or Neuritis. Though the MRI did visualize the Medial Plantar proper digital nerve(MPPDN), it did not indicate that it was enlarged like a Neuroma. Therefore by elimination, the diagnosis was Joplin's Neuritis, or perhaps entrapment of the MPPDN.

    Standing is quite painful, and walking is even worse, so this is something I need to get treated. I am seeing a podiatrist who gave me a few options for treatment.

    1. Low level laser therapy (which he suggested to do first, since it is conservative)
    2. Cortizone injections
    3. Sclerlosing injections
    4. Surgery (though I am in Canada, so the wait time is 1 year, and there are different types of surgeries such as excision via surgical blade, excision via c02 laser, cyro surgery, decompression).

    Thank you in advance for taking the time to help me.
  2. Admin

    Admin Administrator Staff Member

    I would go for the cortisone first.
    Also ask the Podiatrist about different options there are for the use of padding to off load the painful area.
  3. Rjalal

    Rjalal New Member

    The nerve is superficial, will an injection of cortisone cause fat pad atrophy?

    The most painful area is just 1-2 mm medial to the tibial sesamoid. I think I read somewhere that 120-140% of the body's weight is absorbed through the sesamoids when you walk, sounds like a horrible place to inject cortisone which has a weakening effect on soft tissue and bone.
  4. Rjalal

    Rjalal New Member


    I have tried the cortisone injections, I had decreased pain for a couple of days, I went for walks and enjoyed them. But the pain has come back much worse than before.

    If I try alcohol injections, will it result in numbness along the medial plantar 1st MPJ and big toe? If so, what are the consequences of this?
  5. alm

    alm Guest

    did you manage to get rid of the pain? if so, how? thank you

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