Intermetatarsal Neuroma
Neuroma is the thickening of the nerve tissue that surrounds the nerve itself. The thickening is a result of compression and irritation of the nerve at the site. In the foot, it is commonly found in between the metatarsals. Metatarsal bones are located just behind the toes. In the foot, neuroma that is in between the 3rd and 4th metatarsals are referred to as Morton’s Neuroma. Once the tissue thickens, it causes even more pressure and stress on the nerve, causing pain and numbness.
The nerve thickening can be caused by wearing shoes that causes toes to pinched together, such as high heeled shoes. People with certain foot deformities, such as bunions, hammertoes, flatfeet, or excessively flexible feet are at greater risk of developing neuromas. Sports that involve repetitive trauma to the area can also cause neuromas to development.
Symptoms:
The symptoms of neuroma begin gradually, but progressively worsens. The pain is often present when wearing shoes, with relief after taking the shoes off. People with neuromas of the foot often complain of tingling, burning and numbness radiating to the toes. Other patients describe a dull pain which feels like sometime is inside of the ball of the foot when walking. Many patients state the pain is like the shoe or sock is bunched up when walking.
Diagnosis:
History of the symptoms and careful examination of the foot is important. The foot and ankle specialist will attempt to reproduce the symptoms by pinching the site of the neuroma. If necessary, imaging such as ultrasound or MRI may be ordered. Earlier diagnosis of neuroma often leads to less invasive treatments.
Treatments:
Conservative treatment for neuroma involves symptom relief, and prevention of further irritation of the nerve itself.
If symptom relief is not able to be achieved, or the symptoms worsen, then surgical consideration may be considered. Surgical treatment may involve excision (removal) of the nerve causing the discomfort.
Neuroma is the thickening of the nerve tissue that surrounds the nerve itself. The thickening is a result of compression and irritation of the nerve at the site. In the foot, it is commonly found in between the metatarsals. Metatarsal bones are located just behind the toes. In the foot, neuroma that is in between the 3rd and 4th metatarsals are referred to as Morton’s Neuroma. Once the tissue thickens, it causes even more pressure and stress on the nerve, causing pain and numbness.
The nerve thickening can be caused by wearing shoes that causes toes to pinched together, such as high heeled shoes. People with certain foot deformities, such as bunions, hammertoes, flatfeet, or excessively flexible feet are at greater risk of developing neuromas. Sports that involve repetitive trauma to the area can also cause neuromas to development.
Symptoms:
The symptoms of neuroma begin gradually, but progressively worsens. The pain is often present when wearing shoes, with relief after taking the shoes off. People with neuromas of the foot often complain of tingling, burning and numbness radiating to the toes. Other patients describe a dull pain which feels like sometime is inside of the ball of the foot when walking. Many patients state the pain is like the shoe or sock is bunched up when walking.
Diagnosis:
History of the symptoms and careful examination of the foot is important. The foot and ankle specialist will attempt to reproduce the symptoms by pinching the site of the neuroma. If necessary, imaging such as ultrasound or MRI may be ordered. Earlier diagnosis of neuroma often leads to less invasive treatments.
Treatments:
Conservative treatment for neuroma involves symptom relief, and prevention of further irritation of the nerve itself.
- Padding. Padding techniques provide support for the metatarsal arch, thereby lessening the pressure on the nerve and decreasing the compression when walking.
- Icing. Placing an icepack on the affected area helps reduce swelling.
- Orthotic devices. Custom orthotic devices provided by your foot and ankle surgeon provide the support needed to reduce pressure and compression on the nerve.
- Activity modifications. Activities that put repetitive pressure on the neuroma should be avoided until the condition improves.
- Shoe modifications. Wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels.
- Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
- Injection therapy. Treatment may include injections of cortisone, local anesthetics or other agents.
If symptom relief is not able to be achieved, or the symptoms worsen, then surgical consideration may be considered. Surgical treatment may involve excision (removal) of the nerve causing the discomfort.