Neuromas in Feet

OVERVIEW

A neuroma is when a nerve in the foot between the third and fourth toes becomes compressed due to factors such as improper footwear and repetitive stress. This neuroma will result in a variety of symptoms, including pain, swelling, and tingling. These symptoms can be fixed both surgically and non-surgically, but a specific treatment plan will be created to best suit the severity of your own unique case of the neuroma.

ANATOMY

Neuromas in feet are also known as pinched nerves. There are many nerves inside of the foot that allow you to move them. These nerves become pinched or compressed due to things such as improper footwear and too much stress applied to the foot. Once the nerve has become pinched, and a neuroma is formed, some form of treatment is necessary to stop pain as well as other problematic symptoms.

DESCRIPTION

Foot neuromas, also known as Morton’s neuroma, occur in the balls of the foot between the third and fourth toes. It feels like there is a small pebble in your shoe. This “pebble” is actually the thickening of the tissue around one of the nerves leading to your toes, causing a sharp, burning pain in the ball of your foot.

Although the exact causes of neuromas are unknown, there are some factors that can trigger them, including:

• Biomechanical deformities, such as a high-arched foot or a flat foot, causing instability around the toe joints, leading to the development of a neuroma.
• Trauma, which can result in the inflammation or swelling of the nerve.
• Improper footwear, like high heels.
• Repeated stress, especially from sports.

SYMPTOMS

The symptoms of a neuroma are:

• Swelling between the toes.
• Tingling and numbness in the ball of the foot.
• Pain in the ball of the foot when weight is placed on it.
• Pain in the forefoot and between the toes.

DIAGNOSIS

Your Florida Orthopaedic Institute physician will look at your symptoms and health to help determine your diagnosis. Your physician may also order x-rays to view the affected area to ensure that you have a neuroma and not another condition.

TREATMENT (OVERVIEW)

There are both surgical and nonsurgical treatments available for neuromas. Surgical procedures are not usually recommended unless nonsurgical treatment are unsuccessful, or if the neuroma is severe.

NON-SURGICAL TREATMENTS

The type of nonsurgical treatment you will receive is decided based on how severe your neuroma is. If your neuroma is mild to moderate, then possible treatment options may include:

• Icing. Icing the affected area will help reduce swelling.
• Padding. Wearing padding in the affected area will provide support for the foot, lessening the pressure on the nerve.
• Activity Modifications. Activities that apply stress to the neuroma should be avoided.
• Shoe Modifications. Shoes with a wider toe box will help keep pressure off of your neuroma, allowing it to heal.
• Orthotic Devices. Your Florida Orthopaedic Institute physician may provide you with custom orthotic devices that will provide foot support, reducing the pressure on your neuroma.
• Medications. Medications such as ibuprofen may be recommended to help reduce inflammation and pain.
• Injection Therapy. Cortisone, local anesthetics, or other agents may be injected to help reduce your symptoms.

SURGICAL PROCEDURES/TREATMENTS

Surgical treatments are only recommended when nonsurgical treatment options have been exhausted, and symptoms have not improved. There are various surgical procedures available for neuromas – all involve removing the inflamed and enlarged nerve. Your physician will help to determine the best surgical procedure for your specific case of neuroma.

NEXT STEPS

Since each neuroma case needs a different treatment method, your Florida Orthopaedic Institute physician will walk you through your own unique recovery process. Additionally, your physician will recommend long-term measures to help prevent the neuroma from reoccurring. These measures include appropriate footwear and modification of activities that apply repetitive pressure and stress to the foot.