A neuroma is an enlarged, benign growth of nerves, most commonly between the third and fourth toes. Neuromas are caused by tissue rubbing or compression against and irritating the nerves. The most common type of neuroma is more commonly known as Morton's neuroma, which can cause neuropathy of the area between the toes nerve in the front of the foot due to entrapment of the nerve. Morton's neuroma most frequently develops in the third digital interspace, usually in response to irritation, trauma or excessive pressure. While the exact cause of Morton’s neuroma is not known, it is thought to be related to hypermobility (excessive movement) of the metatarsals and repetitive motions which grind the nerve between the foot bones and results in a stinging, burning pain.
Neuromas are more common in women than men possibly due to shoe gear, they affects middle-aged persons, the third common digital nerve is most commonly affected, and neuromas are the most common nerve disorder of the foot. The main cause is trauma to the nerve, but can also be caused by poor shoe gear, foot deformities, activities, and obesity. Pressure from poorly fitting shoes or an abnormal bone structure can also lead to this condition. Symptoms may include sensations of thickness, burning, numbness, tingling, or pain in the ball of the foot. The most common sign is localized pain in the third interspace between the third and fourth toes due to forces of adjacent bones. Pain can also occur in the second interspace but is less common. The pain is described as burning, cramping or sharp and frequently radiates to the toes. Patients may feel as if they are “walking on a wrinkle” in their sock. Pain is less severe when patient is non-weight bearing, or not standing on it.
There are several clinical signs and symptoms a podiatrist can do as beginning treatment. Clinically he can manipulate the foot in the area of pain, take x-rays, and have the patient go for an MRI for evaluation. Once the clinical examination is completed there are several conservative treatments that can implemented before surgery is even considered. Many patients find relief with conservative treatments and are able to avoid surgery. Treatments include but are not limited to wearing roomier, lower-heeled footwear, at home exercises, metatarsal padding to disperse weight away from neuroma, icing/rest- to reduce swelling, therapeutic massage, strapping and taping to the afflicted area, orthotics, oral anti-inflammatory OTC medications, and injections of an anesthetic to relieve pain and a corticosteroid to reduce inflammation. In severe cases, surgical removal of the growth may be necessary. Surgical excision or a neurectomy may be recommended in certain cases.
Neuromas can present with pain that limits movement of the foot and toes during ones regular daily activity. Many conservative and surgical interventions are employed to reduce associated pain with effective results. If you are experiencing these symptoms you can start with wearing the properly fitting and type shoe, and icing the area. If your pain persists, you should seek the opinion of a professional, Dr. Theall. He will be able to provide you with the proper treatment and evaluation of the foot pain you are experiencing. Feel free to come or call Dr. Theall’s office, Gentle Touch Foot Care for a full comprehensive and thorough evaluation to discuss your foot health.
For more information, contact our East Orange office at 973-673-FOOT (3668).