What Is a Neuroma?
A neuroma is a thickening of nerve tissue that may develop in various parts of the body. If you have severe foot pain, numbness, or tingling, and often feel like you need to take off your shoe and rub the bottom of your foot, you may have a neuroma. The most common neuroma in the foot is a Morton’s neuroma, which occurs between the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma.
“Intermetatarsal” describes its location in the ball of the foot between the metatarsal bones. Neuromas may also occur in other locations in the foot. The thickening, or enlargement, of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates enlargement of the nerve, eventually leading to permanent nerve damage
An untreated neuroma can eventually lead to permanent nerve damage. If you suspect that you have developed this condition, it is best to address sooner rather than later. Do not be afraid as neuromas are generally easy to treat.
For an examination and/or to discuss the latest methods of treatment for a neuroma, make an appointment with Dr. Levine at our Park Avenue office in New York by scrolling down to the ‘Make an Appointment’ section below! And if you aren’t sure what is going on with your foot – don’t worry. Just select ‘General Consultation’ and you can discuss it privately in person with Dr. Levine during your appointment.
Causes of Neuroma
The main cause of developing a neuroma is compression or irritation of the nerve can lead to the development of a neuroma. One of the most common offenders is wearing shoes that have a tapered toe box, or high-heeled shoes that cause the toes to be forced into the toe box.
People with specific foot deformities – bunions, hammertoes, flatfeet, or more flexible feet – are at higher risk for developing a neuroma. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running or court sports. An injury or any other type of trauma to the area can also lead to a neuroma.
Symptoms of Neuroma
- Tingling, burning, or numbness
- A feeling that something is inside the ball of the foot
- A feeling that there’s something in the shoe or a sock is bunched up
Progression of Morton’s Neuroma
The progression of a Morton’s neuroma often follows this pattern:
- Gradual symptoms. At first they occur only occasionally and sporadic, when wearing narrow-toed shoes or performing certain aggravating activities.
- May be temporarily once shoes have been removed, massaging the foot, or by avoiding aggravating shoes or activities.
- Symptoms persist over several weeks at a time.
- May become more intense as the neuroma enlarges and the temporary changes in the nerve become permanent.
Non-Surgical Treatment of Neuroma
When considering your treatment plan, one must determine how long you’ve had the neuroma and evaluate its stage of progression. Treatment approaches vary depending on the severity of the condition.
For mild to moderate neuromas, treatment options may include:
- Padding. Properly placed padding can lessen the pressure on the nerve, decreasing pain and repetitive injury to the nerve.
- Icing. Placing an icepack on the affected area helps reduce swelling.
- Orthotic devices. Custom orthotic devices provided by your foot and ankle surgeon provide the support needed to reduce pressure and compression on the nerve.
- Activity modifications. Activities that put repetitive pressure on the neuroma should be avoided until the condition improves.
- Shoe modifications. Wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels.
- Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
- Injection therapy. Treatment may include injections of cortisone, local anesthetics or other agents.
When Is Surgery Needed for Neuroma?
Surgery may be the appropriate step in patients who have not responded adequately to the non-surgical treatments. The length of the recovery period will vary, depending on the procedure performed.
Regardless of surgical or nonsurgical treatments, long-term measures to help keep your symptoms from returning will be advised. These include appropriate footwear and modification of activities to reduce the repetitive pressure on the foot.