Posts for tag: Neuroma
Are you dealing with pain, burning, tingling or numbness between your toes or in the ball of the foot? If you said “yes” then you could be dealing with a neuroma, a pinched nerve or benign tumor of the nerve that is often found between the third and fourth toes.
The classic symptom of a neuroma is pain, particularly when walking—a factor that leads many people to liken the condition to feeling like a pebble is in their shoe. You may find that the pain eases up whenever you aren’t walking or when you rub the pained area with your hands. While neuromas can happen to anyone, they are most commonly found in women.
While the causes of a neuroma are still not clear, there are factors that can increase the likelihood of developing one, such as:
- Extremely high arches
- Flat feet
- Trauma that leads to nerve damage in the feet
- Improper footwear (high heels over two-inches tall; pointed toes)
- Repeated stress placed on the foot
Treating a Neuroma
A neuroma will not go away on its own, so it’s important to see a podiatrist if you are experiencing any of the condition's symptoms. The type of treatment or treatments recommended to you will depend on the severity of the neuroma.
Those with minor neuromas may be able to lessen symptoms by wearing shoes that provide ample room for the toes and offer thick soles that provide more support and cushioning for the toes and balls of the feet. Sometimes a podiatrist may recommend custom orthotics to place inside the shoes, as well.
Your podiatrist may also recommend padding or taping the ball of the foot to improve faulty biomechanics and reduce discomfort. While medication will not eliminate the problem, it can temporarily alleviate symptoms. Over-the-counter anti-inflammatories can often briefly reduce pain and swelling, but for those dealing with more severe pain, steroid injections may be necessary to ease symptoms.
Surgery for a Neuroma
Surgery only becomes necessary when conservative treatment options have failed to provide relief, or when the neuroma has progressed enough that conservative care won’t be enough. During surgery, the inflamed nerve is removed through a simple outpatient procedure. Afterward, there is a short recovery period of a couple of weeks before patients are able to move about pain-free once again!
Give us a Call!
If you are dealing with new or worsening foot pain it’s important that you turn to a podiatrist that can help give you the answers you need. Schedule an appointment today.
The following are some of the ways my patients have described the pain from a neuroma: “It feels like I’m stepping on a pebble,” “I feel like my sock is wadding up under the ball of my foot,” “I feel a burning pain between my toes,” and sometimes “my 3rd and 4th toes are numb – is it diabetes?” Well, it’s not diabetes (in most cases). It is most likely a common condition called a Morton’s Neuroma, something we podiatrists treat daily.
What exactly is a Neuroma?
It’s actually a bit of a misnomer. It is not a tumor at all. It is in fact a swollen, inflamed nerve located between the bones at the ball of the foot. It can be between the 2nd and 3rd toes or the 3rd and 4th toes. The nerve can actually become so enlarged that it pushes the toes apart when you stand up (called a Sullivan’s sign). It is seldom found between the big toe and 2nd toe or between the 4th and 5th toes.
Who gets it?
Mostly adults, but occasionally I have seen it in teens. Women are more likely to suffer from a neuroma. Perhaps due to the shoes they wear. High heels can cause the foot the slide down in the shoe and compresses the ball of the foot in the toe box. Participating in high-impact athletic activities such as jogging or running may subject your feet to repetitive trauma which can also lead to a neuroma. Foot deformities like bunions, hammertoes and flatfeet can also be predisposing factors.
So, how do we diagnose it?
In most cases, clinical findings alone are sufficient. A positive mulder sign is when the doctor squeezes the ball of the foot with one hand, while concomitantly putting pressure on the interdigital space (on the bottom of the foot between the two metatarsal bones) with the other hand. A click can be felt as well as pain in most cases. An ultrasound and/or MRI can also be used for diagnostic purposes, but the neuroma can sometimes be missed with these imaging studies.
How do we treat it?
A custom orthotic with a metatarsal pad included to relieve pressure from the neuroma is usually the first line treatment. Steroid injections can also be very helpful to decrease the inflammation. Another kind of injection called a sclerosing injection (alcohol based) can also be used to deaden the nerve. These injections are usually given in a series (every 10 days or so – anywhere from 5 to 10 total). If conservative care fails there are also surgical treatment options. There are two kinds of surgery for neuromas: one releases the ligament compressing the nerve and the other involves removing the nerve. Happily, most people recover with conservative care alone and do not need surgery but if conservative care fails surgery can be a welcome relief from the constant pain.