A neuroma is a painful condition, also commonly referred to as a “pinched nerve”, a Morton’s or a traumatic neuroma.
The nerve which is commonly affected is the third communicating branch of the medial and lateral plantar nerve of the fore-foot.
This nerve supplies the third and fourth toes and their intervening web space and when this nerve is affected, we name the neuroma a “Morton’s neuroma”.
If the neuroma affects the second or big toe (Hallux), we call it a Joplin’s neuroma.
A neuroma (traumatic neuroma) is an abnormal enlargement of a nerve caused by excessive pressure from surrounding bony structures.
A reduction of fibro-fatty padding, tight-fitting footwear, high-heels, walking on hard surfaces, increased body weight and a sudden change and increase of activity can also exaggerate the symptoms.
Symptoms of a Neuroma may include:
• Feeling that you are “walking on a marble”
• Intermittent burning or sharp type pain commonly affecting the 3rd and 4th toes
• Tingling and numbness in the ball of the foot
• Swelling between the toes
• Pain in the ball of the foot when weight is placed on it
• Irritation and pain particularly in high-heeled shoes
• Irritation and pain particularly in tight, narrow shoes, compressing the toe bones and pinching the nerve.
Treatment options vary with the severity of each neuroma. Severe, regular symptoms may demand surgical correction. X-ray and MR investigation may be necessary to confirm a diagnosis.
If surgery is recommended, techniques can aim at reducing the pressure from, or removing the offending neuromas. Treatment is undertaken on a day stay basis with no need for hospitalisation.
For simple, undeveloped neuromas, a pair of thick-soled shoes with a wide toe box is often adequate treatment to relieve symptoms, allowing the condition to diminish on its own.
Anti-inflammatory drugs and cortisone injections may be used to ease acute pain and inflammation caused by the neuromas, however, they may not offer long-term relief.
To arrange a consultation, or if you have any questions relating to your foot problem, please feel free to contact my rooms and we will do our best to help.
Supplied by Stefan R. Edwards FNZCPS MChS, Podiatric Surgeon Dip.Pod.Surg.B.Sc.(Hons)Pod.Med.M.NZ.C.Pod.Surg.