[dgblanco]

Onset of numbness in both feet after unusually hot and difficult bike ride (after 15 years of very active bicycling). Bike shoes may have been too tight. Left foot symptoms less severe and gradually went away. Right foot is same or worse after 4 months. Feels like middle 3 toes and surrounding area are half-asleep. Is numbness and tingling a predescessor to more severe pain symptom of MN? Or, is another diagnosis more likely? What treatments are favored for my symptoms?

[footankledoc]

Morton's neuroma can cause some numbness in the toes mainly in the 3rd/4th toes as well as pain. It's usually a progressive onset and if the foot is squeezed into a biking shoe, the years of irritation can finally make the nerve inflammed causing numbness or transient numbness as in your L foot which then ends up leading to pain. You have many options for treatment. These include orthotics, occasional cortisone injections (not more than 3/yr), and change of shoegear. There are newer treatments such as sclerosing injections which can help reduce the inflammation of the nerve. This is a once a week injection for up to a series of 7 which can dramatically reduce the inflammation of the nerve and sometimes can reduce numbness. If change of shoes, orthotics, injections, and pads don't work, then you are left with more invasive procedures such as excision of the nerve, releasing the ligament that causes entrapment of the nerve, and coblation of the nerve. I would seek treatment from a local podiatrist. Hope this helps!