Neuromas

A neuroma is a painful growth of nerve tissue in the foot—between the third and fourth toe bones. It forms when bones in the feet press together and irritate a nerve.

Causes:

Neuromas often form by wearing tight or poorly fitted shoes, by repeated stress on the foot, or women who wear high heels frequently. Injury or a foot deformity can also cause a neuroma. As a neuroma gets worse, it can cause a lot of pain and keep you from activities you enjoy.

Symptoms:

  • A sharp, burning pain in the ball of the foot, especially when walking. Many people try to ease the pain by rubbing their foot
  • Tingling or numbness between the toes and in the ball of the foot
  • A feeling that you have a stone in your shoe, or that your sock is wrinkled
  • A painful lump that reproduces your symptoms when touched

Neuromas

Physical Exam:

Your doctor will ask about your symptoms, any history of foot or nerve problems, and have a foot exam. During the exam, your doctor will gently press on different parts of your foot which helps locate the source of the pain.

Diagnostic Tests:

Certain tests can help diagnose a neuroma and help rule out other problems, such as pain caused by a stress fracture.

  • X-rays show bone and joint problems
  • Ultrasound uses sound waves to view tissues in the foot
  • Nerve blocks numb the area around a nerve (locates problem)
  • MRI provides images on bones and soft tissues in the foot

Treatments:

In most cases, painful symptoms can be reduced without surgery. For severe problems, your doctor may recommend treating the nerve directly. Left untreated, neuromas often get worse.

Reducing Symptoms:

Shoe Changes and Orthotics
Shoe with good support, a wide toe box, and thick soles can help prevent nerve irritation. Avoid wearing high heels. If needed, custom shoe inserts (orthotics) can help improve foot function and provide extra support for your feet.

Padding and Tapping
Padding and adhesive tape may be placed on the ball of the foot. This can help correct abnormal foot function and decrease pressure on the nerve.

Physical Therapy
Massaging your feet and using ice packs can help reduce pain and swelling. Sound waves or whirlpools can also help provide relief.

Medication
Your doctor may prescribe anti-inflammatory medications to reduce tissue swelling. Cortisone injections are sometimes used to relieve swelling in the nerve.

Treating the Nerve:

Surgery:
Surgery may be used to remove the neuroma. This can be done in the doctor’s office, a surgical center, or a hospital. During surgery, a local anesthetic numbs your foot. An incision is then made to remove the nerve. You can usually go home he same day, Ask your doctor when you can get back on your feet. You can often resume normal activities within 3-6 weeks.

Injections:
Injections of an alcohol substance (sclerotherapy) may be used to permanently numb the nerve. The injections are done in your doctor’s office and take just a few minutes to perform. Several treatments are usually needed.

Keeping Feet Healthy:

  • Wear supportive shoes that are roomy enough for you wiggle you toes
  • Avoid high heels
  • Avoid activities that put a lot stress on the foot, such as jumping or running on hard or uneven surfaces