Neuromas

A neuroma is a painful thickening of a nerve in the foot, usually caused by chronic irritation, compression, or trauma. The most common type is a Morton’s neuroma, which occurs in the 3rd intermetatarsal space (between the 3rd and 4th toes).

Patients often describe the pain as burning, tingling, numbness, or the sensation of “walking on a pebble” in the ball of the foot.

Neuromas are often related to narrow or tight shoes, high heels, repetitive forefoot stress, or abnormal foot mechanics.

Treatment Plan

• Shoe Modification: Wear wide toe box shoes with cushioned soles. Avoid high heels and narrow shoes.
• Padding: Metatarsal pads help spread the metatarsal bones and reduce nerve compression.
• Topical medication: Lidocaine cream/gel can relieve painful symptoms
• Injections: Corticosteroid or alcohol sclerosing injections may help shrink or calm the inflamed nerve.
• Surgery: If conservative treatment fails, surgical excision of the neuroma may be performed. Numbness is the most common side effect of these surgeries. In 10%-30% of cases, the neuroma can reoccur- to mitigate this, at SpecOrtho we take the neuroma and
  will often imbed the loose end into a soft tissue, muscle, or bone to prevent recurrence.

Avoid:

• Narrow, tight, or high-heeled shoes that pinch the forefoot.
• Prolonged standing or high-impact activity without proper footwear.