Neuroma

What Is Neuroma?

A neuroma is an enlargement or thickening of nerve tissue. Neuromas can be found throughout the body in various places. In the foot the most common neuroma is the Morton's neuroma found in the third webspace or between the third and fourth toe usually at the level of the third and fourth metatarsal. The enlargement of the nerve is the direct result of compressive forces that damages the nerve and cause significant pain especially upon ambulation.

Symptoms: Pain associated with a neuroma will progress over time. Usually the patient will experience pain associated with a nerve trauma such as tingling, burning, or numbness. Patients have a feeling that they are walking on rocks or that there is something in their shoe. At first relief of the symptoms may come from simply removing shoes that crowd the foot or massaging the foot. As the condition progresses and more trauma happens to the nerve the symptoms may persist for days to weeks with no relief.

Diagnosis: This is usually made by the foot and ankle surgeon following a complete history of symptoms and physical exam. The pain experienced associated with a neuroma can be recreated by manipulating the foot which will compress the nerve causing symptomatic pain. However, if a recreation of the pain isn't achieved and a neuroma is still suspected the foot and ankle surgeon can order imaging studies such as an MRI to view the enlarged nerve.

Causes

A neuroma is caused by any type of compression force or irritation of a nerve. Common causes include tight fitting shoes especially ones that are narrow in the toe box and shoes that force the toes into the toe box, such as dress shoes and high heel shoes. However, there are certain structural deformities of the foot such as bunions, hammertoes, and flatfeet, that have commonly been associated with the development of a neuroma. Also, certain athletic activities especially running and playing on hard surfaces have been associated with neuroma development. This is due to the repetitive trauma or irritation to the ball of the foot.

Treatment

After evaluation or symptoms your foot and ankle surgeon will usually develop a treatment plan based on the severity of symptoms. Mild to moderate symptoms may respond well to modifying any activities that produce pain as well as anti-inflammatory medications and utilizing padding and strapping to decompress the nerve providing relief. Custom orthotic devices have also proven useful in decompressing the nerve and providing support and relief from neuroma pain. Also, it may be advised that you modify your shoe gear to a shoe that provides more room in the toe box so the foot isn't crowded in the shoe. Injection therapy with the use of a steroid and a local anesthetic can also be used in the treatment process. In some cases surgery may be needed to alleviate the symptoms associated with a neuroma especially if the above conservative treatment plans fail.

If you feel like you have a neuroma or are suffering from symptoms associated with this condition please visit any of our five locations, Savannah, Hinesville, Statesboro, Claxton, or Bluffton and speak with our podiatrists to create a treatment plan perfectly suited to you and your needs.