Neuroma

A neuroma is a nerve tissue growth often located between the third and fourth toes. Although benign, a neuroma can be painful with a burning sensation or numbness.
Neuroma

Neuroma

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Table of Contents

Introduction - Neuroma

A neuroma is a nerve tissue growth often located between the third and fourth toes. Although benign, a neuroma can be painful with a burning sensation or numbness.

Commonly called a Morton’s neuroma, this problem begins when the outer coating of a nerve in your foot thickens. This thickening is usually caused by irritation that results when two bones repeatedly rub together (often due to ill-fitting shoes or abnormal bone movement). The area between the third and fourth toes is the most commonly affected; the area between the second and third toes is another common irritation point. Nerve problems due to diabetes or alcoholism may also cause neuroma-like symptoms.

Factors That Can Contribute to a Neuroma

  • Biomechanical deformities like a flat foot or high arch.
  • Improper shoes that squeeze the toe area. High heels can also apply excess pressure to the toes.
  • Repeated stress to the toes and ball of the foot.
  • Trauma.

Symptoms of a Neuroma

The pain from neuromas may start gradually, causing burning, tingling, cramping, or numbness. Symptoms often occur after you’ve been walking or standing for a period of time. It might feel like you’re stepping on a lamp cord. You may need to take your shoe off and rub your foot. In some cases, the pain radiates from the tip of the toes to the ankle.

Neuroma symptoms include:

  • Pain between the toes when walking
  • Feeling like there is a stone in the shoe.
  • Numbness or tingling in the ball of the foot.
  • Pain in the ball of the foot with weight-bearing.
  • Swelling between the toes.

Treatment

If you suspect a neuroma, try some home treatment. Switch to shoes with plenty of toe room and low heels. Proper shoes will have shock-absorbent soles and insoles to keep excessive pressure off your foot.

Rest your foot as much as possible and ice to relieve discomfort. Massaging the area can temporarily ease neuroma pain.

When these methods don’t work, it’s time to visit your podiatrist. Left untreated, neuromas may worsen. The earlier it is treated, the sooner the neuroma will heal.

We will relieve the pressure from the area. Padding the ball of the foot can relieve neuroma symptoms. Anti-inflammatory medications and cortisone injections can ease pain and inflammation.

Custom-fitted orthotics can help control foot function while they relieve symptoms and prevent worsening.

For more severe neuromas, we will discuss surgery with you. The outpatient surgery removes the enlarged nerve.

Evaluation

To help diagnose your problem and determine the best treatment for your neuroma, your podiatrist looks at your medical history, thoroughly examines your foot, and performs any necessary tests.

Medical History and Physical Exam

Your podiatrist talks with you about your symptoms, the frequency of your pain, and any past medical history that could involve nerve problems. Then your podiatrist examines your foot carefully, palpating (pressing) the areas around the neuroma to determine the extent of your pain.

Tests

X-rays may be used to help identify a possible neuroma, or to rule out other causes of pain. Ultrasound, which uses sound waves to show internal soft tissue, may also be performed. Another diagnostic test, which can also relieve pain, involves blocking the nerve by injecting anesthesia around it. Occasionally, magnetic resonance imaging (MRI) may be done to reveal cross-sectional images of soft tissue and bone.

How Does My Podiatrist Treat Neuromas?

After your evaluation, your podiatrist will talk with you about the most appropriate care for your neuroma. Nonsurgical treatment methods may include orthotics, medication, ultrasound, or shoe adjustments.

Nonsurgical Care

Orthotics

Custom shoe inserts adjust the structural support of your foot, helping to prevent irritation to the nerve.

Medication

Cortisone injections or other medication can relieve pain and swelling in the nerve’s outer coating.

Ultrasound Therapy

Sound waves may help reduce swelling around the neuroma.

Shoe Changes

Pads can cushion and support the parts of your foot that are vulnerable. Roomy, supportive shoes can help prevent irritation.

Will I Need Surgery?

If nonsurgical care does not help, surgery may be necessary to remove the neuroma. A local anesthetic may be used for this procedure. The surgery may be done in your podiatrist’s office, a surgical center, or a hospital.

After Surgery

Following your surgery, you may feel numbness (possibly permanent) in the area where the nerve was removed. Your podiatrist will tell you how soon you can be on your feet. Usually, you can return to normal activities within three to six weeks.

What Can I Do About Neuromas?

Shoes can make all the difference. Be sure they’re supportive—and roomy enough for your toes to wiggle. Avoid certain movements, such as squatting and knee-bending, which can irritate the nerve. See your podiatrist if your symptoms continue or other foot problems arise.