A neuroma is a painful condition that affects the front of the foot between two of the toes. Although it can occur between any of the toes, it is most commonly found between the third and fourth toes. Common symptoms of a neuroma include:
- Pain in the front part of the foot
Sufferers of neuromas commonly describe the sensation as if they are walking on a stone or a rolled-up sock. In some cases, the pain may radiate into the toes or along the bottom of the foot.
What Exactly is a Neuroma?
A neuroma is a benign thickening of the nerve that runs between the metatarsals and branches to the toes. Also known as “perineural fibrosis,” a neuroma produces significant pain in the foot because the inflamed nerve is trapped under the ligament that connects the metatarsal bones. Because of this, tight shoes, high-heels, and rigorous activity involving the feet will usually aggravate the condition. The pain can sometimes be partially relieved by removing the shoe and gently rubbing the affected area.
How is a Neuroma Diagnosed?
The patient will undergo an initial x-ray to rule out any fractures or foreign bodies within the affected foot. Once it has been determined that the foot has no evidence of fractures or foreign bodies, then the diagnosis is made by the treating Podiatrist by correlating the clinical symptoms.
In cases that prove difficult to diagnose, there are two additional tests that may be required. The first test is a gadolinium MRI and the second test is a diagnostic ultrasound. It is important to note that these tests are expensive and require the expertise of a radiologist specially trained in performing a musculoskeletal MRI or a diagnostic ultrasound. However, at Pennsylvania Foot and Ankle Associates, we treat a great number of patients suffering from neuromas, so these additional tests are seldom necessary.
How is a Neuroma Treated?
There are several different ways a neuroma can be treated through conservative means. The following treatment methods have proven to be effective at treating most cases of neuroma:
- Padding or elevating the metatarsals
- Shoe inserts
- Physical therapy
- Anti-inflammatory medications
- Laser therapy
At Pennsylvania Foot and Ankle Associates, we also offer a NEW treatment program that consists of a series of local injections that shrinks and eliminates the affected nerve completely.
When is Surgery Needed?
If conservative treatment has not been successful and the patient has not received adequate relief from pain, then surgical removal of the neuroma can be performed in our office or as an outpatient procedure under local anesthesia with mild sedation.
Generally, there are two surgical approaches to treating a neuroma: the affected nerve is either removed or it is released. Your foot and ankle surgeon will determine which approach is best for your condition.