What do Neuromas Feel Like?
Neuromas usually cause pain in the forefoot, especially in the area of the 3rd and 4th toes. The nature of the pain may be shooting, burning, stabbing, radiating and/or just an odd feeling in the area. One of the classic findings is relief of symptoms with removal of shoe and massaging the area.
What Is A Neuroma?
The classic Morton's neuroma is a fibrous thickening of the nerve in the area of the 3rd and 4th toes.
What Causes A Neuroma?
The exact cause is unclear. However, it is thought the bones, metatarsals, on either side of the nerve pinch the nerve causing inflammation and thickening. Known contributing factors are tight shoes, especially slip on shoes, high-heeled shoes and biomechanical dysfunction such as flat feet. Also, injury or foot sprains may cause a neuroma.
General Neuroma Information:
• Occurs in all adult age groups
• More common in females
• Usually affects only one foot but may affect both
• Usually affects the nerve behind the 3rd and 4th toes
How Do I Know If I Have A Neuroma?
• Clinical examination by a physician (usually feels for a palpable click between the metatarsal heads).
• Diagnostic local anesthetic injection - mandatory prior to surgery.
• X-ray of the foot to rule out other foot pathologies.
When Should I Start Treating My Neuroma?
Neuromas should be treated if they are painful, limiting activities or limiting the shoes you can wear.
What Will Happen If I Don't Have My Neuroma Treated?
It is difficult to predict the sequelae and rate of progression of an untreated neuroma. Usually if a neuroma is untreated the following occurs:
• Growth of the neuroma
• Increased discomfort in the area
• Inability to wear certain shoes
• Inability to perform some job duties
• Need for surgical removal
Conservative Treatment of Neuromas
Usually, conservative therapy is attempted prior to surgical intervention. Conservative options include the following:
• Well fitting, lace-up shoes with a wide toebox
• Padding
• Orthotics/OTC Arch Supports
• Injections of local anesthetic and/or corticosteroids
• Physical therapy
Conservative treatment generally has a 50% chance of relieving symptoms. See your podiatrist as soon as possible after symptoms begin - early conservative treatment improves your chances of avoiding surgery.
When Is Surgery Indicated?
When conservative therapy has failed to provide adequate relief of symptoms or conservative treatment options are impractical.
What Is Involved In Neuroma Surgery?
Surgery is usually performed under local anesthesia with IV sedation. After
surgery you will have to keep your foot dry for two weeks. Generally neuroma
surgery allows for early weight bearing and protection in some type of post
op shoe gear for three to four weeks. The severe nerve pain is relieved almost
immediately after surgery. Some neuromas may reoccur, but this is rare.
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