NEUROMAS

What are neuromas?

Commonly called a Morton’s neuroma, this problem occurs when the outer coating of the nerve in your foot thickens.  This thickening is usually caused by irritation that results when two bones rub repeatedly together often due to poor fitting shoes or abnormal bone movement.  The areas between the third and fourth toes are most commonly affected with the area between the second and third toe being second most commonly affected.  Nerve problems due to diabetes or alcoholism may also cause neuroma like symptoms.

Symptoms:  The pain from neuromas may start gradually, causing burning, tingling, cramping, or numbness.  Symptoms also may occur after you have been walking or standing for a period of time.  It may feel like you are stepping on a rock or a pebble or you may feel like a sock was rolled or bunched up under your toes.

Often times, the pain radiates from the tip of the toe to the ankle.

Evaluation: To help diagnose your problem and determine the best treatment of your neuroma, Dr. Honick will look at your medical history, thoroughly examine your foot, and perform any necessary tests. Dr. Honick will talk with you about your symptoms, the frequency of your pain, and any past medical history that could involve nerve problems.

Then Dr. Honick will carefully examine your foot, palpating the areas around the neuroma to determine the extent of your pain. Certain tests may be needed to help rule out other causes of pain. X-rays may be used to help identify any bony abnormalities or fractures. Ultrasound, which uses sound waves to show internal soft tissues, may also be performed. Another diagnostic test which can also relieve pain involves blocking the nerve or injecting anesthesia around it. Occasionally, magnetic resonance imaging (MRI) may be done to reveal cross-sectional imaging of soft tissue and bones.

How are neuromas treated?

After your evaluation, Dr. Honick will talk with you about the most appropriate care for your neuroma. Nonsurgical treatment methods may include custom-molded foot orthotics, nonsteroidal anti-inflammatory medications, ultrasound, or shoe modification.

Will I need surgery?

If nonsurgical care does not help, surgery may be necessary to remove the neuroma. The surgery is done either in a hospital or surgical center. A portion of the affected nerve is removed. Following surgery, initial numbness (possibly permanent) will be noted in the area where the nerve was removed. Dr. Honick will tell you how soon you can be on your feet. Usually, you can return to normal activities within three to six weeks.