What is a Neuroma?
A neuroma is a painful
condition, also referred to as a “pinched nerve” or a nerve tumor. It is a
benign growth of nerve tissue frequently found between the third and fourth
toes. It brings on pain, a burning sensation, tingling, or numbness between the
toes and in the ball of the foot.
The principal symptom
associated with a neuroma is pain between the toes while walking. Those
suffering from the condition often find relief by stopping their walk, taking
off their shoe, and rubbing the affected area. At times, the patient will
describe the pain as similar to having a stone in his or her shoe. The vast
majority of people who develop neuromas are women.
Causes
Although the exact
cause for this condition is unclear, a number of factors can contribute to the
formation of a neuroma:
§ Biomechanical deformities, such as a
high-arched foot or a flat foot, can lead to the formation of a neuroma. These
foot types bring on instability around the toe joints, leading to the
development of the condition.
§ Trauma can cause damage to the nerve,
resulting in inflammation or swelling of the nerve.
§ Improper footwear that causes the toes to be
squeezed together is problematic. Avoid high-heeled shoes higher than two
inches. Shoes at this height can increase pressure on the forefoot area.
§ Repeated stress, common to many occupations,
can create or aggravate a neuroma.
§ Hallux limitus at the level of the 1st
MPJ joint is often associated with a neuroma involving the 2nd
interspace.
§ High intensity sports such as surfing,
running, hiking can predispose a patient to developing a neuroma.
Symptoms
The symptoms of a
neuroma include the following:
§ Pain in the forefoot and between the toes
§ Tingling and numbness in the ball of the foot
§ Swelling between the toes
§ Pain in the ball of the foot when weight is
placed on it
Home Treatment
What can you do for
relief?
§ Wear shoes with plenty of room for the toes to
move, low heels, and laces or buckles that allow for width adjustment.
§ Wear shoes with thick, shock-absorbent soles,
as well as proper insoles that are designed to keep excessive pressure off of
the foot.
§ High-heeled shoes over two inches tall should
be avoided whenever possible because they place undue strain on the forefoot.
§ Resting the foot and massaging the affected area
can temporarily alleviate neuroma pain. Use an ice pack to help to dull the
pain and improve comfort.
§ Use over-the-counter shoe pads. These pads can
relieve pressure around the affected area.
When to Visit a Podiatrist
Podiatric medical care
should be sought at the first sign of pain or discomfort. If left untreated,
neuromas tend to get worse.
Diagnosis and Treatment
Treatment options vary
with the severity of each neuroma, and identifying the neuroma early in its
development is important to avoid surgical correction.
For simple,
undeveloped neuromas, a pair of thick-soled shoes with a wide toe box is often
adequate treatment to relieve symptoms, allowing the condition to diminish on
its own. For more severe conditions, however, additional treatment or surgery
may be necessary to remove the tumor.
The primary goal of
most early treatment regimens is to relieve pressure on areas where a neuroma
develops. Your podiatric physician will examine and likely X-ray the affected
area and suggest a treatment plan that best suits your individual case.
Padding and Taping: Special padding at the ball of the foot
may change the abnormal foot function and relieve the symptoms caused by the
neuroma.
Medication: Anti-inflammatory drugs and cortisone
injections can be prescribed to ease acute pain and inflammation caused by the
neuroma.
Orthotics: Custom shoe inserts made by your
podiatrist may be useful in controlling foot function. Orthotics may reduce
symptoms and prevent the worsening of the condition.
Surgical Options: When early treatments fail and the
neuroma progresses past the threshold for such options, podiatric surgery may
become necessary. The procedure, which removes the inflamed and enlarged nerve,
can usually be conducted on an outpatient basis, with a recovery time that is
often just a few weeks. Your podiatric physician will thoroughly describe the
surgical procedures to be used and the results you can expect. Any pain
following surgery is easily managed with medications prescribed by your
podiatrist.
A endoscopic
decompression surgery can be done is
some cases.
Prevention
Although the exact
causes of neuromas are not completely known, the following preventive steps may
help:
§ Make sure your exercise shoes have enough room
in the front part of the shoe and that your toes are not excessively
compressed.
§ Wear shoes with adequate padding in the ball
of the foot.
§ Avoid prolonged time in shoes with a narrow
toe box or excessive heel height (greater than two inches).
Dr. Stacy Witfill
11786 cedar street
Dunnellon, FL 34431
352-489-6621
