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Monday, April 22, 2013

Neuroma Pain: Vitamins B and D

Dr. Blake,

Here is the latest update. The right foot neuroma pain has maybe gone down around 30% since my cortisone shot 6 days ago. Although now I am beginning to have very sharp nerve pain in my left foot pad area. It happens when I am walking and step-off. The pain is a sharp nerve pain located just below the big toe in the foot pad area. The pain will shoot across into the foot pad area just below the 2nd and 3rd toe. This nerve pain is also located in my right foot now. It is identical to the left foot area in both the type of pain and location. So in essence I have 3 issues going on; Mortons Nueroma (right foot - between 3rd and 4th toe), Metatarsalgia/Nerve Nueropathy in the right foot pad area, Metatarsalgia/Nerve Nueropathy in the left foot pad area. I have no other pains in my body besides my feet. I have flat feet and I over pronate when I walk (as verified by my shoe wear pattern). I also did the electronic foot pad test which showed my pressure points and I was all deep red in the foot pad area and the base of the heel.
Dr Blake's comment: I will have to look into the test you deserve, for I have not heard about it. But, you presentation of nerve pain shows what happens when you stir up one nerve, the others seem to chime in quite easily and without much provocation. The nervous system is a super highway from brain to feet with small switches in the back area. It is easy to hurt one nerve in one location, and have symptoms develop in other adjacent nerves or the same nerves in the opposite foot. It is interesting to study, but not to have. 

As mentioned, I am 39 years old, don't drink, don't smoke, not overweight, I had my blood work done about 6-8 months ago and all was OK except for Vitamin D deficiency, which I have been taking 5,000units per day as per my doctor recommendation. I have since dropped down to 1,500 units per day in the past 2 months. My glucose levels were fine. Never tested for mercury levels or Vitamin B levels.
Dr Blake's comment: Glad you are working on the Vit D. This deficiency can cause a lot of foot pain, and I should be testing this more. What is your level right now? Our lab is 30 to 85 normal, but I want my athletes around 55 if they are competitive. Definitely get a B12 level drawn, simple enough to do. 

Very frustrating to be dealing with all of this but from what I gather it can be poor foot mechanics and/or Vitamin B deficiency. I have started to take Vitamin B supplements. Blood tests done 8 months ago did NOT check for Vitamin B levels. Right now I am taking Vitamin B12, B1, B6, Magnesium. I have also increased my fish oil intake along with Olive Oil intake to help with inflammation.
Dr Blake's comment: This is great. Vitamin B is known to cause foot nerve pain when low, and overall inflammation can be reduced by modifying what you eat. 

I also started using New Balance orthopedic shoes, along with arch support inserts (Powerstep ProTech Control w/ 2 degree medial post) and metatarsal pads. This has helped A LOT and for house walking I have slippers with metatarsal pads and arch supports, which has also made a big difference. Long gone are the days where I could walk barefoot on my tile floor :(
Dr Blake's comment: I love the Hapad Longitudinal Medial Arch Pads with the adhesive backing. Typically the small size works well with most. It is placed behind the sore area and can be quite miraculous for nerve pain like you describe.

Have you ever had patients with Vitamin B deficiencies that caused Metatarsalgia? If so, what is the timeline to see nerve pain reduction in those cases? I read online about 3-6 months.
Dr Blake's comment: First you get the Vitamin B to normal levels, then you wait 3-6 months to see if it helps. Of course it can help. It is one of those deficiencies that has well been documented to cause nerve pain. Sure hope this has helped some. 

Appreciate any advice or input would be apprecaited. Pretty bummed out dealing with this foot pain...


Diamondhead on a somewhat cloudy day!!


  1. Have you ever tried injecting B12 near the nerve irritated by a neuroma? Supposedly it stimulates nerve repair. I've been reading about it as a treatment, but haven't found a local podiatrist that offers it. I'm in Berkeley, California.

  2. I just answered on my blog today 10-27-18. Contact Dr. Ajitha Nair 510-775-2431 and see if she will give the injections to you. Rich

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.