The anatomy of the human foot is quite complicated. Other important structures lie beneath the skin which includes the muscles, blood vessels, bones, joints, ligaments, tendons, and nerves.
Foot neuromas affect the nerves – the bundle of axons (like electrical cables) serving as communication channels between any part of the body and the brain. Nerves allow the feet and toes to move while maintaining balance. They also provide the foot sensations for the brain to process.
Foot Neuromas are nerve tissue thickening. They can develop anywhere in the body as long as there are nerves. The most common area of neuroma is between the third and fourth toes. Neuroma on this area is called “intermetatarsal” neuroma because they develop in the ball of the foot between metatarsal bones – the long tubular bones found at the mid-foot.
Risk Factors for Foot Neuromas
The thickening of the nerve is a result of nerve irritation. It may result from:
- wearing of ill-fitting shoes (tapered toe box/ high-heeled)
- certain foot deformities (hammertoes, flat feet, bunions, or flexible feet)
- repetitive activities irritating the ball of the foot (common to athletes/runners)
Symptoms of Foot Neuromas
Foot neuromas may have one or more of the following where the nerve damage is occurring:
- The feeling of something on the ball of the foot
- Tingling or burning sensation
- Numbness in the toes
- Pain or discomfort
Symptoms begin gradually and wear away when shoes are off, or after a massage, and rest. Over time, symptoms worsen and become more intense as the nerve thickening grows larger and becomes permanent.
How is Foot Neuroma Treated?
Treatment for foot neuromas varies depending on the extent and severity of symptoms. A physician may recommend one or more of the following treatment options:
Non-surgical Treatment for Foot Neuroma
Customized devices that are applied externally to:
- provide support to the feet or ankle
- accommodate deformity
- decrease the pressure on the affected nerve
- assist rehabilitation
- reduce pain
- correct alignment
- increase mobility
Ice-heat pack therapy
Ice pack helps reduce inflammation, thereby lessening pain. An ice pack can be used for 15-20 minutes and at least 2-3 times per day. However, an ice pack should be avoided if there are other problems such as sensation or circulation problems.
Usually, after ice compress, heat packs are applied as a contrast therapy. Ice and heat packs are used alternatively. Heat packs, however, should be applied for no more than 15 minutes to avoid burns.
While ice therapy reduces swelling, heat therapy promotes blood flow that helps to speed up the healing process.
Padding such as metatarsal pads helps loosen the bones in the ball of the foot, lessening pressure and compression on the nerve.
Shoes should be wide enough and not narrow-toed. High heels should also be avoided. Continuing to use ill-fitting shoes aggravates the pain and worsens the condition.
Repetitive activities such as running, or walking should be avoided especially if it is the cause of neuroma.
Physical therapy includes stretching, toe exercises, massage, and ankle exercises. It is an essential part of the treatment plan as it promotes healing and aids in pain reduction.
Anti-inflammatory and analgesics may be prescribed to reduce inflammation and pain.
Injection therapy involves the use of steroid and local anesthesia to prevent inflammation and reduce pain.
Surgery for Foot Neuroma
Surgery may be suggested to patients whose symptoms have not improved
Some individuals with neuroma feel better after decompression surgery. This operation involves cutting of structures near the thickened nerve to relieve pressure.
Removal of neuroma
Surgical removal of a foot neuroma may be needed if other treatments do not work. Excision of the neuroma can reduce the pressure and tension on the surrounding compressed nerves. The surgery, however, can still result in numbness of the affected toes.
If you suspect you have foot neuroma, contact us to discuss different options with one of our podiatrists.
- “Normal Anatomy and Compression Areas of Nerves of the Foot and Ankle: US and MR Imaging with Anatomic Correlation.”Web. <http://pubs.rsna.org/doi/pdf/10.1148/rg.2015150028>.
- “Metatarsal bones – Wikipedia.” Wikipedia, the free encyclopedia. <http://en.wikipedia.org/wiki/Metatarsal_bones>.
- “Ball (foot) – Wikipedia.” Wikipedia, the free encyclopedia. <http://en.wikipedia.org/wiki/Ball_(foot)>.
- “About orthoses and prostheses – The Australian Orthotic Prosthetic Association Ltd. (AOPA).” Welcome to AOPA – The Australian Orthotic Prosthetic Association Ltd. (AOPA). <http://www.aopa.org.au/careers/what-are-orthoses-and-prostheses>.
- “Morton’s Neuroma (Intermetatarsal Neuroma).” Connecticut Orthopaedic Specialists | New Haven, Branford, Guilford, Hamden, Milford, Orange, Shelton, Wallingford. <http://www.ct-ortho.com/pdf/Morton_DeLott.pdf>.
- “Understanding Neuromas: A Pinched Nerve in the Ball of your Foot.” My HealtheVet Veterans Health Library. <http://www.veteranshealthlibrary.org/Resources/Flipbooks/Orthopaedics/229452_VA.pdf>.
- ” Morton’s neuroma – Diagnosis and treatment – Mayo Clinic.” Mayo Clinic. <http://www.mayoclinic.org/diseases-conditions/mortons-neuroma/diagnosis-treatment/drc-20351939>.
- “Morton’s Neuroma treatment options – Neuroma Specialists.” Avoid Foot Neuroma Surgery | Morton’s neuroma treatment. <http://www.mortonsneuroma.com/mortons-neuroma/treatments-mortons-neuroma/treatment-conservative-options-mortons-neuroma/>.
- “Surgical Treatment of Morton’s Neuroma: Pressure Relief or Excision | Joint-surgeon.com.” Joint-surgeon.com | Orthopedic Joint-Surgeons Germany | Excellent and Affordable Hip, Knee, Ankle, Shoulder Spine Surgery. <http://www.joint-surgeon.com/orthopedic-services/foot-and-ankle/mortons-neuroma>.
- “Nerve Conduction Studies. Medical investigations, information | Patient.” Symptom Checker, Health Information and Medicines Guide | Patient. <http://patient.info/health/nerve-conduction-studies>.