A neuroma is a painful condition, also referred to as a “pinched nerve” or a nerve tumor. It is a benign growth of nerve tissue frequently found between the third and fourth metatarsal bones, but can be found anywhere in the body. It brings on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot. At times, the patient will describe the pain as similar to having a stone in his or her shoe. The vast majority of people who develop neuromas are women, usually due to shoe gear.
Biomechanical deformities, such as a high-arched foot or a flat foot, can lead to the formation of a neuroma.
Often neuromas are hard to treat without professional care as they tend to get worse over time. Podiatric care should be sought at the first sign of pain or discomfort.
Neuromas can be successfully treated with conservative care, including.
Padding—Often padding is the first step in a treatment plan. Padding forefoot minimizes trauma to the area, thereby minimizing pain. This allows the patient to continue a normal, active life.
Shoe Gear Modification—Larger toe boxes and wider shoes can be used to accommodate the forefoot, which decreases pressure across the forefoot and relieves pain.
Custom-Molded Orthotic Devices—Custom-made shoe inserts made by our physicians may be useful in controlling foot function and reducing pressure on the nerve.
Stretching and Physical Therapy—Stretching the calf muscles can reduce the amount of forefoot pressure, thereby decreasing trauma to the nerve
Medication—Topical anti-inflammatory medication, oral anti-inflammatory medication (such as ibuprofen), and cortisone injections into the area of pain are very successful at decreasing the inflammation at the neuroma, thereby decreasing the pain.
When early treatments fail and the neuroma progresses past the threshold for such options, podiatric surgery may become necessary. The procedure, which removes the inflamed and enlarged nerve, can usually be conducted on an outpatient basis, with a recovery time that is often just a few weeks. Any pain following surgery is easily managed with medications and rest.