A neuroma is the swelling of a nerve as a result of a compression trauma, often described as foot tumors though they are not actually a tumor in the purest sense. Neuromas are usually found in the ball of the foot and can lead to permanent nerve damage if not properly treated. The compression trauma that the ball of the foot experiences is usually caused by abnormal movement of the metatarsals. A small nerve passes between the spaces of the metatarsals and splits into a “Y” form to enter into the toes. When this area gets pinched it causes the swelling of the neuroma. Patients can experience burning pain, tingling, and numbness in one or two of the toes and sometimes this pain can become so severe the patient may become immobile. As the nerve continues to swell it can be felt as a popping sensation when walking and will become worse as the nerve is continuously pinched. Neuromas can form in between the third and fourth toes, also called a Morton’s Nueroma and between the second and third toes.
A podiatrist will diagnose a neuroma after a thorough physical exam and evaluation of the patient’s history with this condition. X-rays may be taken to make sure that the pain is not in fact cause by a stress fracture or other conditions with similar symptoms of a neuroma. Because nerve tissue is not seen in X-rays, the neuroma will not be present in the results. A skilled foot specialist will actually feel the neuroma during a physical exam of the foot.
Treatment for neuromas can include cortisone injections, orthotics, chemical destruction of the nerve, or surgery. Initial treatments usually consist of cortisone injections because they can shrink the swelling of the nerve and alleviate the pressure on the nerve. While this is a good first step, the abnormal movements of the bones will continue to aggravate the nerve requiring a different solution to cure the neuroma. A common treatment combined with injections to treat neuromas is foot orthotics. These devices are custom-made inserts for the shoes that correct the abnormal metatarsal movement. If however, there is significant damage to the nerve the podiatrist will suggest two choices for removal of the neuroma: chemical destruction of the nerve or surgical removal or decompression of the nerve.