A neuroma is a thickening or enlargement of nerve tissue that can lead to tingling, burning, numbness, pain and other discomfort. Neuromas, thickening of the nerve tissues, can develop all over the body. The most common neuroma in the foot is called a Morton’s neuroma, sometimes called an intermetatarsal neuroma, and develops between the third and fourth toes. However, neuroma’s can develop in other places on the foot as well. Compression and irritation to the nerve cause the thickening, or enlargement of the nerve, and can lead to permanent nerve damage if left untreated.
Neuromas can cause tingling, burning, numbness, pain, or the sensation that something is inside the ball of the foot, or that something is bunched in the shoe or sock. Symptoms usually begin gradually, only appearing occasionally, usually when wearing narrow-toed shoes, or doing certain activities. The symptoms may go away when the shoe is removed, or the foot is massaged. Over time, however, the symptoms worsen and the discomfort can last for several days or weeks at a time. The symptoms become more intense as the neuroma enlarges and the changes in the nerve become more permanent. See your podiatrist as soon as you notice symptoms–the earlier the diagnosis, the less the need for invasive treatments or surgery.
Anything causing compression or irritation of the nerve can lead to a neuroma developing. Wearing tight shoes, shoes with narrow toe boxes, or high-heeled shoes that squish the toes are the main causes of neuroma development. Some foot deformities, like bunions, hammertoes, flatfeet, or flexible feet, provide a higher risk for developing a neuroma. Activities involving repetitive irritation to the ball of the foot, like running or court sports, can also lead to neuromas. Sometimes, neuromas can develop after an injury or other trauma to the area.
Treatment options depend on how long you’ve had the neuroma, and on its developmental stage, and vary depending on the severity of the neuroma.
For mild to moderate neuromas:
- Padding. Certain padding techniques support the metatarsal arch, reducing the pressure on the nerve, decreasing the compression on the nerve during walking and other activities.
- Icing. Icing the affected area reduces swelling, and therefore pressure.
- Orthotic devices. Custom orthotic devices provided by your podiatrist provide the support needed to reduce pressure and compression on the nerve.
- Modify your activities. You may need to avoid certain activities that put repetitive pressure on the neuroma until the condition improves. You’ll be able to discuss your particular situation with your podiatrist.
- Appropriate footwear. Wear shoes with a wide toe box, and avoid narrow-toed shoes or shoes with high heels. Don’t wear shoes that are too small or too tight.
- Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDSs), such as ibuprofen, may help reduce pain and inflammation.
- Injection therapy. Cortisone, local anesthetics, or other pain and inflammation-reducing agents may be injected into the affected area to reduce pain and swelling
For more severe cases, or cases that aren’t improving with the non-surgical methods, surgery may be required. Even after surgery, to prevent further complications, you’ll need to wear appropriate footwear and avoid activities that aggravate the situation.