Do you experience sensations of, burning, numbness, thickness, electrical “shooting”, or tingling in your toes or in the ball of your foot? Do these sensations occur in the area of your second, third or fourth toes? Is the pain relieved by removing your shoes and/or massaging your feet?
These are some of the symptoms experienced by those suffering from a common foot complaint known as a neuroma. It is also called a Morton’s neuroma. A neuroma is a thickening of nerve tissue that may develop commonly in the foot. Almost always a benign (non-cancerous) condition, a neuroma is caused by an irritation or compression of a nerve in the ball of the foot. It is usually described as a gradually increasing pain located most commonly between the base of the third and fourth toes. The involved nerve is sometimes squeezed and irritated by the adjacent metatarsal bones causing the painful neuroma to develop.
A neuroma may be the result of excessive rolling or “pronation” and/or from wearing poorly designed and fitted shoes. A diagnosis of neuroma is based on the symptoms described by the patient. Sometimes an ultrasound or MRI can be used to assist in the diagnosis.
During the examination for a neuroma, squeezing the metatarsal heads together often causes pain (Mulder’s Sign) and a popping sensation is felt as the neuroma moves between the adjacent metatarsal heads.
Treatment with Orthotics
Conservative treatment can begin with padding the foot with a metatarsal pad. Orthotic devices are very effective for treating this problem. Other treatments include anti-inflammatory drugs, local steroid injections, Ethanol Ablation, and changing the type of shoe worn. Early diagnosis and treatment of the problem will increase the success of conservative care.
Surgical removal of the involved nerve growth can provide effective relief from the most serious neuromas. The surgery involves the identification and removal of the abnormal nerve growth. Removal of a small portion of the nerve does not affect walking or standing. The patient can walk on the foot immediately following surgery wearing a special surgical shoe and can return to work usually within a few days. A dressing stays on the foot for two weeks.