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A neuroma is a benign growth in the tissue surrounding a nerve. This growth causes an enlargement of the nerve, which can lead to pain. Neuromas are fairly common in the feet, and are typically seen in the intermetatrsal nerves. These are the nerves that run up the metatarsal bones in your foot. The most common site for a nueroma to form is in the third intermetatarsal space, which is in the ball of the foot between the third and fourth toes. This is referred to as a Morton’s Neuroma.
Morton’s Neuroma can occur in anyone, but is most typically seen in females between the ages of forty and sixty. Early symptoms of a neuroma may include sharp or shooting pains in the affected area, a burning sensation in the area, or numbness and tingling in the toes. Many of these symptoms may resolve with rest and taking off the shoes, and you may feel some relief from rubbing the area. A common compliant of patients with a Morton’s Neuroma is that it feels like they are stepping on a pebble, or that there is a lump in their shoe.
There is no single clear cut reason that neuromas form, but there have been several proposed mechanisms. The one that is the most universally accepted is the idea that the neuroma is a response to the pressure of the metatarsals sqeezing on the nerve. This may be due to poorly fitting shoes, especially high heels. Why it occurs so frequently at the third intermetatarsal nerve in particular may be due to the thickness of this particular nerve – it is slightly thicker than the other intermetatarsal nerves.
The clinical picture of a neuroma is usually enough to diagnose the problem, but x-rays are usually taken to rule out things like stress fractures and other problems. MRI may also be used to diagnose neuromas more definitively, but due to cost is not generally done.
Treatment of neuromas including Morton’s Neuroma may include a change in shoes, padding, orthotics, medications, injections, and physical therapy. Generally a wider shoe will help relieve some of the pressure on the neuroma, which is often the source of the pain. Padding the area underneath the ball of the foot can also prevent the nerve from being pinched by the bones. Orthotics are typically used to treat biomechanical problems such as over-pronation, which may be the underlying cause of a neuroma. Injections of steroids as well as oral pain-relief medication are typically used in the acute setting, but will not address the underlying cause of the neuroma.
Ultimately, you and your doctor may decide that surgery is an option. This is generally a decision that will have to be made after some other therapies are employed first.
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Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com
