Have you ever felt that burning, tingling, or maybe even a shooting pain under the ball of your foot, that you just can’t put your finger on? Sometimes it may feel as if you have something in your shoe, but there isn’t anything there when you go to look. Does the pain get worse at the end of the day, or when you get on a nice pair of dress shoes? Or maybe you have swelling between your toes…
If you do have some or all of these symptoms, you may have a neuroma.
A neuroma is really an inflammation and a thickening of the nerves between your toes. The most common place for a neuroma in the foot is between the 3rd and 4th toes, because the nerve here is the thickest of all the other intermetatarsal nerves. The inflammation of this nerve is called Morton’s Neuroma.
A number of factors may contribute to the formation of a neuroma. The underlying factor is either trauma or pressure on the nerve involved. Tight shoes, and high heels which squeeze the toes together and cause increased pressure on the nerve between the toes, could lead to the development of a neuroma. Biomechanical factors, such as having flat feet or high arched feet can also create increased pressure between the toes and can cause a neuroma.
Things that you could do at home to alleviate the discomfort and pain:1. Wear wider shoes which have a wide toe box, so that your toes and your feet have room to move around. 2. Wear low heels or sneakers. Do not wear high heels.3. Rest, ice and massage the area of pain. This may temporarily relieve your symptoms.
If the pain still persists for longer than 2 weeks and you have tried these home remedies, then you may have to contact your podiatrist for medical treatment of the neuroma.
A Podiatrist may recommend various treatment options, depending on how severe your neuroma is. The first thing a Podiatrist may do is to take an Xray. This will not show a neuroma, but it will help to rule out other causes of the pain in the ball of your foot, such as a stress fracture. A stress fracture can often be mistaken for a neuroma.
Treatment for a neurma includes:1. Rx Medication (Anti-inflammatories, such as Motrin/Naprosyn) that will help to decrease the inflammation of the neuroma, and thereby decrease the pain.2. Neuroma pads which will help to disperse the pressure from the affected area. 3. Custom Molded orthotics which will aid in the proper functioning of your foot, especially if the neuroma is caused by a biomechanical factor, such as a high arch or flat feet.4. Steroid injections maybe an option. The steroid is mixed with an anesthetic and injected into the nerve. This amount of steroid will not affect your body, but it will act as an anti-inflammatory to decrease the inflammation and the pain. 5. The last option to consider is a surgical option. There are various surgical methods to remove a neuroma. One of the most conservative approaches is cryosurgery whereby an instrument is used to freeze the offending nerve. After the nerve is frozen, it will no longer cause any pain. Another common approach is to surgically remove the inflamed nerve which is causing the irritation and discomfort.
Contact your podiatrist if you notice that the pain and discomfort does not resolve with the home treatments mentioned above for the neuroma. Do not wait longer than 2 weeks if the symptoms are persistent. Diagnosis and treatment of a neuroma is essential in its early stages, and will help to avoid the need for surgery.
By: Dr. Sharon Joag