Neuromas

A neuroma is a painful condition that occurs anywhere in the body, such as the hands, but often in the feet. If you sometimes experience the sensation of “walking on a marble” and have persistent pain in the ball of your foot, you might be dealing with a type of neuroma.

What Is a Neuroma?

A neuroma, a “pinched nerve” or a nerve tumor, is a benign growth of nerve tissue commonly found in the feet. It causes pain, burning sensation, tingling or numbness in the toes and the ball of the foot. The primary symptom associated with neuromas is pain between the toes while walking. Some patients with a neuroma describe the pain as similar to having a stone in their shoe. The majority of people who develop neuromas are women.

The symptoms of a neuroma include the following:

• Pain in the forefoot and between the toes
• Tingling and numbness in the ball of the foot
• Swelling between the toes
• Pain in the ball of the foot when pressure is applied

Morton’s or interdigital neuroma is another common type of foot neuroma. The condition is not a benign nerve tumor but a tissue thickening surrounding the digital nerve leading to the toes. This type of neuroma grows between the third and fourth toes. Morton’s neuroma can lead to varying pain and discomfort in the forefoot, which can interfere with a person’s ability to perform certain activities.

Other terms for Morton’s neuroma include Morton’s metatarsalgia, interdigital neuritis or a plantar neuroma. Morton’s neuromas occur around eight times more frequently in women than in men and typically affect individuals aged 30 to 60, although they can also develop outside of this age range.

What Causes a Neuroma?

Like all types of neuromas, the cause of Morton’s neuroma remains unclear. However, several factors can contribute to the development of this condition:

• Biomechanical deformities: High-arched feet or flat feet can lead to neuroma development. These foot types cause instability around the toe joints.
• Trauma: Nerve damage due to trauma can result in nerve inflammation or swelling.
• Improper footwear: High-heeled shoes more than two inches tall tend to squeeze the toes together and increase pressure on the forefoot area.
• Repeated stress: Neuromas are primarily caused by stress and pressure placed on the foot.

Treatment options for neuromas vary based on their severity. Early diagnosis is crucial to avoid surgical intervention. Morton’s neuroma treatment typically involves a combination of one or more of the following approaches to achieve longer-lasting relief:

• Footwear changes: Avoid high heels and tight, narrow shoes. Choose thick-soled shoes with a wide toe box, lower heels, and soft soles to allow the bones to spread out, helping reduce pressure on the nerve and promoting healing.
• Orthotics: Personalized shoe inserts and metatarsal pads/bars can be added to the shoes for maximum comfort. These adjustments help relieve irritation by altering pressure distribution on the forefoot and separating the bones.
• Injections: Corticosteroid (steroid) injections can relieve nerve swelling and inflammation. Nerve ablation, another type of injection, permanently stops pain signals from the nerve.

However, more severe cases may require additional treatments or neuroma removal surgery.

What Is a Neuroma Surgery?

When conservative treatments prove ineffective and a neuroma progresses beyond manageable levels, neuroma surgery may be the next step. This outpatient procedure involves either removing the affected portion of the nerve or releasing the tissue around it. Surgery is often the most reliable treatment for Morton’s neuroma, with success rates ranging from 80-95% and a short recovery period.

Various surgical techniques have been shown to yield similar outcomes. Incisions can be made on the top or bottom of the foot, directly over the affected area. Once the nerve is accessible, the surgeon may remove the swollen segment or release surrounding tissues to relieve compression. The specific approach depends on individual factors, so remember to have a detailed discussion with your surgeon.

Find a Neuroma Surgeon in San Antonio

If left untreated, neuromas tend to worsen.

Healthcare is better together. To schedule an initial consultation with a neuroma surgeon at the Vascular Institute of San Antonio, connect with our network of providers here or call 210-962-5709.