A neuroma, sometimes referred to as a Morton's neuroma, is a common disorder which typically causes symptoms in the ball of the foot. The symptoms can include pain (sharp or dull), burning, tingling, numbness, or a feeling of walking on a folded or bunched up sock. The pain is usually most significant in the ball of the foot just behind the 3rd and 4th toes but may occur in other areas. The symptoms may also radiate into the toes.
A neuroma is caused by a thickening or irritation of the nerve that runs between the long bones in the foot (the metatarsals) and innervates (feeds) the toes. The irritation of the nerve can be caused by shoes, activities (especially ones that involve repetitive stress on the ball of the foot), certain foot-types or foot deformities such as bunions and hammertoes. An acute injury to the foot can also sometimes lead to a neuroma.
During the treatment of your neuroma, your podiatrist may perform x-rays to rule out other causes of your pain. These typically can be performed quickly and easily right in the office.
Treatment of a neuroma can include padding which can help support the arch and reduce pressure on the ball of the foot. Ice can also be helpful.
You and your podiatrist will need to determine if your shoes are contributing to the problem. If so, these should be changed.
Your podiatrist will also need to determine if the activities you participate in are contributing to the neuroma. If so, these will need to be modified.
Oral medications such as non-steroidal anti-inflammatory medications like ibuprofen may be prescribed to treat a neuroma. By themselves, they are typically not enough to resolve the problem.
Foot orthotics may be created by your podiatrist. Orthotics are an important part of the short and long term treatment of a neuroma.
Steroid or cortisone injections are a commonly performed treatment modality for neuromas. Cortisone is effective in reducing the thickening and irritation of the nerve.
If these treatments are not successful, the nerve typically needs to be removed by surgery or by chemical destruction. Chemical destruction is performed by injecting a chemical around the nerve. The chemical is safe for the rest of the body but it selectively destroys the nerve.
If conservative treatment is unsuccessful in relieving the symptoms of a neuroma, the diseased portion of the nerve is typically surgically removed. This is usually done under IV sedation (twilight) or can be done with just local anesthesia. The incision is typically made on the top of the foot so that you can walk immediately after the surgery.
For more information, please see our neuroma video.