A neuroma is a result of a persistent benign fibrotic enlargement of a nerve. This may occur to digital nerves, between the toes. The most common neuroma occurs at the 3rdinterspace, known as Morton’s neuroma. The thickening of the nerve develops as a consequence of repetitive trauma or entrapment of the nerve.
The pain from neuromas may be nonspecific including a variety of symptoms such as burning, tingling, numbness, or the sensation of a foreign object. Pain may be elicited by shoe gear that has a narrow toe box. The pain or neuralgia is commonly unilateral. Pain may worsen to the point where a person is unable to tolerate closed toe shoes. Patients may describe feeling like they are walking on a pebble or that their sock feels bunched up under the ball of their foot.
Upon physical examination, your podiatrist may try to reproduce pain by palpating the interdigital spaces or by squeezing the foot. They also may order imaging to rule out other lesions or arthritis as a cause of pain. Treatment for the neuromas includes shoe gear changes, such as a wider toe box to prevent compression. Your podiatrist may recommend orthotics with metatarsal pads or bars to provide more space between metatarsal heads. A local anesthetic or corticosteroid injections may be offered to help reduce symptoms. Alcohol injections may be offered to chemically ablate the nerve. If conservative treatment fails, surgical excision of the neuroma may be an option. Call your podiatrist today if you have questions or concerns about neuromas.
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