Reference Library

Neuromas

A neuroma (also referred to as a “pinched nerve”) is a benign growth of nerve tissue found between the lesser toes. It can cause pain, a burning sensation, tingling between the toes and in the ball of the foot.

The principle symptom is pain between the toes while walking. Those suffering often find relief by stopping, taking off their shoes and rubbing the affecting area. At times, the patient may describe the pain as having a stone in their shoe. The majority of the patients who develop neuromas are women.

Causes

Although the exact cause of this condition is unclear a number of factors can contribute to the formation of a neuroma:

  • Biomechanical deformities, such as high-arch foot or flat foot can lead to the formation of a neuroma. These foot types cause instability of the toe joint, leading to the development of this condition 
  • Trauma can cause damage to the nerve, resulting in inflammation of the nerve
  • Any kind of footwear which causes the toes to be squeezed together
  • Repeated stress, common in many occupations, can aggravate a neuroma

Symptoms

The symptoms of a neuroma include the following:

  • Pain in the forefoot between the toes
  • Tingling and numbness in the ball of the foot
  • Swelling between the toes
  • Pain in the ball of the foot when weight is placed on it

What can you do for relief?

  • Wear shoes with plenty of room for the toes to move, low heels and laces or buckles that adjust for width.
  • Wear shoes with thick, shock-absorbent soles, as well as proper insoles designed to keep excessive pressure off the foot.
  • Avoid shoes with heels higher than 2 inches, as they place undue strain on the forefoot.
  • Resting the foot and massaging the affected area can temporarily relieve neuroma pain. Use an ice pack to help dull the pain and use over-the-counter shoe pads. These pads can relieve pressure in the affected area.
  • Podiatric medical care should be sought at the first sign of pain or discomfort. If left untreated, the neuromas tend to get worse.

Diagnosis and treatment

For a simple underdeveloped neuroma, wearing a pair of thick-soled shoes with a wide toe box is often adequate treatment to relieve symptoms and allows the condition to diminish on its own. For more severe conditions, additional treatment or surgery may be needed to remove this benign tumor.

The goal of early treatment regimens is to relieve pressure where the neuroma develops. Your podiatric physicians will likely x-ray the affected area and suggest a plan that best suits your need:

  • Padding and taping: Special padding at the ball of the foot can change the abnormal foot function and relieve the symptoms caused by the neuroma.
  • Medication: Anti-inflammatory drugs and cortisone injections can usually help pain and inflammation.
  • Orthotics: custom shoe inserts may be useful in controlling symptoms and prevent the worsening of the condition.
  • Surgical options: When early treatments fail, surgery may be necessary. The procedure removes the inflamed and enlarged nerve and is usually performed on an outpatient basis, with recovery often taking just a few weeks. Your podiatric physician will describe the procedure to be used and the results you can expect. Any pain following surgery is managed with pain medications prescribed by your podiatrist.

Prevention

Although the causes of neuroma are not completely known, the following preventive steps may help:

  • Make sure your exercise shoes have enough room in the front part of the shoe so that your toes are not excessively compressed.
  • Wear shoes with adequate padding in the ball of the foot.
  • Avoid prolonged time in shoes with narrow toe box or a heel height greater than 2 inches.

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