Neuromas, or abnormal growth of cells within a nerve, most commonly form between the third and fourth toe bones. Pain is often elicited as a result of these bones pressing together and irritating a segment of a nerve. This may be caused by wearing tight shoes, or by frequent stress on the foot. Women who wear high heels regularly are prone to neuroma formation.
Symptoms of a neuroma begin slowly, but often become progressive. You may feel a sharp, burning sensation in the ball of the foot, especially when bearing weight. Another common symptom is tingling or numbness between the toes and in the ball of the foot. There may also be pain on palpation at the neuroma site. Your podiatrist can perform a foot exam to determine if you have a neuroma. If needed, imaging studies such as X-rays and ultrasound can be done to confirm this condition and rule out other problems.
Fortunately, there are many treatment options available to reduce painful symptoms, and in most cases, without surgery. For example, your podiatrist may first suggest shoe changes. Shoes with good support, a wide toe box, and thick soles can help avert nerve irritation. Getting a proper fit is important. Avoid wearing high heels. If necessary, custom-made shoe inserts (orthotics) can provide support for your feet and prevent the neuroma from getting worse. Other conservative treatments include padding and taping. This can help take pressure away from the irritated nerve. Your podiatrist may also prescribe anti-inflammatory medications to reduce tissue swelling. Cortisone injections may also be used to relieve the nerve inflammation.
If conservative treatments still do not provide relief, your podiatrist may suggest treating the nerve directly in two different ways: surgery or injections. Surgery may be used to excise the neuroma. Upon removal of the neuroma at your podiatrist’s office or hospital, you can usually go home the same day. You can often return to normal activities within 3 to 6 weeks. Injections of an alcohol solution may be utilized to permanently numb the irritated nerve. Although the injections in your podiatrist’s office take just a few minutes, repeated treatments are usually required.
By Kyle Alessi