What is Neuroma?
A neuroma is defined as the thickening of nerve tissue. The most common neuroma in the foot is Morton’s neuroma, which occurs at the base of the third and fourth toes. Neuromas may also occur in other locations of the foot.
If left untreated the thickening of the tissue resulting from the compression–swelling and irritation of the nerve–can result in permanent nerve damage and may spread to adjacent toes.
Symptoms of Morton’s Neuroma
Symptoms of Morton’s Neuroma begins gradually and occasionally, and may worsen over time and last for several days or weeks. The discomfort becomes more intense as the neuroma grows and the nerve changes begin. Symptoms include:
- Tingling, burning, or numbness
- Sharp, dull or throbbing pain
- The feeling that there is a foreign body inside the ball of the foot. Another way to describe this would be that one’s sock is bunched up in the shoe.
A neuroma develops by anything that compresses or irritates the nerve. Shoes that are tight fitting, have a narrow toe box, or have a high heel all result in the toes forced deeper into the toe box.
People with bunions, hammertoes, flatfeet or more flexible feet are more prone to developing a neuroma. Athletes who are involved in sports with repetitive irritation to the ball of the foot (for example runners or those who play racquet sports) are also at risk.
Treatment
Treatment depends upon the stage of development and severity of the neuroma. Early treatment can minimize the need for more invasive treatments and surgery. Refrain from wearing narrow-toed shoes or performing certain activities is recommended. Massaging the inflamed area will also alleviate discomfort. A MRI or Sonogram will be performed to determine the condition.
Options for mild cases include:
- Padding to lessen the pressure on the nerve and decreases pressure while walking
- Icing to reduce swelling
- Orthotic devices
- Modifying activities that put pressure on the neuroma
- Wearing wider toed shoes
- Anti-inflammatory [ibuprofen] and nonsteroidal drugs
- Injecting with a corticosteroid plus a local anesthetic or sclerosing medications to shrink the damaged nerve
When is Surgery Necessary?
When painful symptoms persist after conservative methods surgical excision is recommended. Recovery time varies and a long-term plan to alleviate the neuroma and its symptoms from returning are required.
