Neuroma

People often present complaining of pain in the front of the foot around the third and fourth toes. One common condition responsible for this pain is a neuroma or Morton’s neuroma.  The following information should help to explain the how and why of a neuroma and what you can do to prevent and resolve this condition.

Signs and Symptoms

• Tingling and/or pain between the third and fourth toes.
• Cramping in the toes.
• Numbness in the toes or on the ball of the foot.
• Inflammation between the toes.
• Pain is worse when walking or applying pressure to the area.
• Severe sharp or burning pain in the ball of the foot and at the base of the toes.

Causes

• Morton’s neuroma is caused by compression and irritation of the nerve between the third and fourth metatarsals.
• Compression and trauma to the metatarsals can irritate and damage and thicken the nerve between the metatarsals.

Risk Factors

• Sex: Women are more likely to suffer from neuroma than men due to increased forefoot loading through footwear.
• Exercise: people who are active and regularly exercise are at an increased risk due to regular and persistent constriction of the nerve.
• Pathology: people with existing biomechanical deformities such as pes planus, pes cavus, bunions or hammertoes, are at an increased risk of neuroma.
• Inappropriate footwear: High heeled and tight fitting shoes will compress the metatarsals and increase the likelihood of developing neuroma.

Treatment

• Avoid restrictive footwear that will irritate the nerve.
• Massage can help to alleviate pain.
• Patients with pre-existing foot complications such as flat feet, high arches, bunions or hammertoes are likely to find their symptoms for neuroma increased by their pre-existing conditions that cause restriction around the nerve. Prescription orthoses can be effective in alleviating the added stress caused by these conditions and thereby reducing and/or eliminating the pain of the neuroma.
• Ultrasound guided injection of local anaesthetics and steroids have been shown to be effective in the management of neuroma symptoms.
• In extreme cases, surgical removal of the thickened tissue around the nerve, or even removal of the nerve itself, can be necessary.

If you suffer from these symptoms and require an assessment or opinion from one of our trained Podiatrists, please contact us for an appointment.

This information has been provided by the Australasian Podiatry Association for it’s members.