Have you ever heard of a neuroma? You might not be familiar with the term, but chances are, you or someone you love have experienced foot swelling, irritation and possible nerve damage caused by neuromas. Neuromas are a prevalent foot issue, affecting one out of three people – primarily women.
Neuromas are a compression-related thickening of your foot’s nerve tissue, causing a tumor-like growth between the nerves. While neuromas can develop in different areas of your foot, Morton’s neuroma is the most common. Patients with Morton’s neuroma typically experience pain and swelling in the medial plantar nerve between the base of the 3rd and 4th toes (on the “ball” of your foot).
The most common causes for neuromas include:
- ● Activities: Vigorous activities involving irritation to the ball of the foot (running, jumping, ballet or yoga) place you at higher risk of developing a neuroma.
- ● Foot deformities: Patients with certain foot deformities such as high arches (pes cavus), bunions, hammertoes, highly flexible feet and flatfoot are at higher risk for getting a neuroma.
- ● Genetics: Neuromas can be genetic and passed down from generation to generation.
- ● Injuries: Any trauma to the midfoot or forefoot – including fractures and ligament or tendon damages – increases your chances of developing a neuroma.
- ● Tight Shoes: Wearing shoes with a tapered toe box or high heels that cause the toes to jam together can cause nerve compression or irritation.
What are the symptoms of a Morton’s neuroma?
Neuroma symptoms begin gradually and worsen over days and weeks as the nerve enlarges and thickens.
“The best time to treat a neuroma is in the early stages of symptoms,” says Sarah Cullen, DPM, a podiatrist at Roper St. Francis Healthcare. “An early diagnosis of a Morton’s neuroma greatly minimizes the need for invasive treatments or surgery.”
If you have a Morton’s neuroma, you are likely to have one or more of the following symptoms:
- ● Cramping in your foot.
- ● Feeling like you’re walking on a bunched-up sock or marble.
- ● Numbness or burning pain of second, third, fourth or fifth toes.
- ● Pain at night and at rest.
- ● Radiating, burning pain traveling up the outside of the leg or outside of the foot.
- ● Sensation that something is stuck inside the ball of your foot.
Neuroma symptoms are commonly misdiagnosed as peripheral neuropathy, which causes weakness, numbness and pain in the hands and feet. A neuroma is a tumor-like mass between the nerves, while peripheral neuropathy is a chronic nerve disorder.
Neuroma treatment options
If you are experiencing mild to moderate neuroma, our podiatry experts recommend conservative treatments first.
Successful neuroma treatment options include:
- ● Activity modifications: Avoid anything repetitive that adds strain on the neuroma, including running, jumping, Pilates, intense yoga, vigorous walking or any other activity that causes pain.
- ● Change shoes: Wear shoes with a wide toe box. Stay away from narrow shoes and high heels.
- ● Icing: Ice the affected area of your foot to reduce inflammation and swelling.
- ● Injection therapy: Injections can dramatically decrease neuroma pain by “shrinking” the neuroma and reducing inflammation.
- ● Medications: Ibuprofen and other NSAIDs (non-steroidal anti-inflammatory drugs) can reduce pain and inflammation. Side effects can include an upset stomach and increased blood pressure, so check with your doctor first.
- ● Orthotics: Arch supports can reduce pressure and compression on the affected nerve. There are two options for orthotics: over-the-counter and custom. Your podiatrist will help you decide the best fit for your needs.
- ● Padding: It might sound simple, but padding techniques help support your foot arch while decreasing nerve compression.
If your neuroma still causes you significant pain after conservative treatments, the final option is surgery. However, our podiatry experts caution only considering neuroma surgery as a last resort.
“Surgery is an option for patients who haven’t gotten relief from other treatments,” says Drennan Josey, DPM, a podiatrist at Roper St. Francis Healthcare. “Conservative treatment should be exhausted before considering surgery, given the risk of complications and that the success rate is only between 80-85%.”
Dr. Cullen and Dr. Josey encourage patients experiencing neuroma symptoms to schedule an appointment with a specialist. Early treatment can slow the progression of a neuroma – and most importantly, help you avoid permanent nerve damage.
Call for an appointment
For more information or to schedule an appointment with a Roper St. Francis Healthcare podiatry team member, please call (843) 402-CARE or visit rsfh.com.