A neuroma is a thickening of nerve tissue that may develop in various parts of the body. The most common neuroma in the foot and is called Morton's neuroma. This lesion commonly occurs between the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma. "Intermetatarsal" describes its location - in the ball of the foot between the metatarsal bones (the bones extending from the toes to the midfoot).
Neuromas may also occur in other locations in the foot.
The thickening, or enlargement, of the nerve defining a neuroma is the result of compression and irritation of the nerve. This compression creates swelling of the nerve, eventually leading to permanent nerve damage.
What are the symptoms of a Morton's neuroma?
If you have a Morton's neuroma, you will probably have one or more of these symptoms where the nerve damage in occurring:
The progression of Morton's neuroma symptoms often follows this pattern:
The symptoms become more intense as the neuroma enlarges and the temporary changes in the nerve become permanent.
Treatment for neuroma. In developing a treatment plan, I will first determine how long you've had the neuroma-type symptoms and evaluate its stage of development. Treatment approaches vary according to the severity of the problem.
It has been my experience in 44 years of practice that this is the most over diagnosed foot malady. In the years that I have been in practice I have found no more then 10 true neuromas. The majority of the "neuromas" are due to either muscle spasm that is pinching the nerve, neuropraxia or joint pain that is mimicking nerve type pain. Other considerations are neuropathies due to anemia, sciatica and diabetes.
For mild to moderate cases of neuroma-type pain, treatment options include:
When is surgery needed? Surgery may be considered if you have not received adequate relief from other treatments. Generally, there are two surgical approaches to treating a neuroma. These are both hospital procedures that either remove or release the affected nerve. I will determine which approach is best for your condition.
The length of the recovery period will vary, depending on the procedure or procedures performed. Regardless of whether you've undergone surgical or nonsurgical treatment, I will recommend conservative and common sense measures to help keep your pain from returning. These include appropriate footwear and modification of activities that can cause repetitive injury to your foot.
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