Slinke - I've had this thing for about 3 years. It's just there. At times, it doesn't bother me at all. I can usually tell when I hit about 35 miles into a ride without looking at my computer as that's when the foot will most likely begin to hurt. As soon as it starts I know to start moving my toes around and unclipping when possible. My neroma is also on my clipped in foot. In other words I always unclip with my right leaving the left attached. It's the left foot that hurts so after 35 miles I start unclipping with left and leaving the right clipped in. It's sometimes awkward but helps alot. And worse comes to worse, I stop, take off the shoe, massage the foot, and am good and able to ride for at least another 10 miles without problems. If doing a century I pretty much have pain no matter what for the last 20 miles or so. Just learned to live with it. Usually its the least of my problems on a century (between butt, shoulders, legs, etc). Also I got some relief changing out my pedal. I went from a Speedplay (which put alot of presure at the base of my toes) to the Dura Ace pedal with spreads the pressure out over the ball of my foot. Problem is the injury is now there so I will always have problems. I also know some shoes cause me more grief than others. I usually rode in Sidi's. I tried the Specialized shoe which is very stiff and the pain came on very swift and very bad. I'm now back in Sidi's. I also don't have much problem with riding my mountain bike. Maybe its because I don't do the same distance but I also think its because I ride with a wide platform pedal (Time Ztac Control). Catch the problem early and hopefully the injury won't become permanent!