A neuroma is a painful, enlarged nerve, usually found in between the toes on the bottom of a patients foot. Symptoms associated with a neuroma include a burning feeling, tingling or numbness in the toes, and a pain that radiates from the bottom of the foot. Some patients with neuromas describe a “clicking” or “popping” when they walk. Others feel like they have a “lump” in the ball of their foot when walking.
Tight fitting shoes and high heels amplify the pressure the bones in the foot place on a neuroma, which can easily exacerbate the condition. The most common site for foot neuromas is between the third and fourth toes; although they can be found in the interspaces between any of the toes.
Early treatment for neuromas include injections of either Sclerosing Alcohol (to shrink the neuroma) or Cortisone (to eliminate the inflammation), which is the cause of the pain and tingling. Physical therapy and oral anti-inflammatory medications are also used to control the pain and inflammation. Custom fabricated orthotics can be fitted with a special neuroma pad that prevents the metatarsals (bones) from creating excessive pressure on the nerve, and are essential components of the conservative treatment regimen.
If conservative care is not effective, radio-frequency treatment can be used to eliminate neuroma pain without incisions or stitches. As a last resort, the neuroma can be surgically removed. Custom orthotics are then used post-operatively to help keep the pressure off the site of the pre-existing neuroma.