Neuromas

A neuroma is a benign tumor of a nerve. Morton's neuroma is not on actual tumor, but a thickening of the tissue that surrounds the digital nerve leading to the toes.
Morton's neuromas are usually found in between third and fourth toes, but can also be found in the other interspaces.

Signs and Symptoms

The most common symptom of Morton's neuroma is localized pain In the interspace between the third and fourth toes. It can be sharp or dull, and is worsened by wearing shoes and by walking. Pain usually Is less severe when the foot is not bearing weight

If you have a Morton's neuroma, you will probably have one or more of these symptoms where the nerve damage in occurring:
• Tingling, burning, or numbness
• Pain
• A feeling that something is inside the ball of the foot, or that there's a rise in the shoe or s sock Is bunched up,

What Caws a Neuroma?

Anything that causes compression or irritation of the nerve can lead to the development of a neuroma, One of the most common offenders is wearing shoes that have a tapered toe box, or high-heeled shoes that cause the toes to be forced into the toe box.
People with certain foot deformities-bunions, hammertoes, flatfeet, or more flexible feet--ire at higher risk for developing a neuroma. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running or racquet sports. An injury or other type of trauma to the arena may also lead to a neuroma.

Diagnosis

The diagnosis of a Morton's neuroma can usually be made be the doctor when the history of pain suggests #t and the examination elicits the symptoms. The foot is usually tender when the involve area Is compressed and symptoms of pain and sometimes tingling can be elicited when the sides of the foot are squeezed. Magnetic resonance imaging (MR]) or ultrasound testing can be used to confirm the diagnosis if necessary

Treatment

In developing a treatment plan, your podiatric surgeon will first determine how long you've had the neuroma and evaluate ft stage of development. Treatment approaches vary according according to the severity of the problem. For mild to moderate cases of neuroma, treatment options include:

Changes in shoewear. It's important to wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels.

Padding. Padding techniques provide support for the metatarsal arch, thereby lessening the pressure on the nerve and decreasing the compression when walking.

Activity modifications. Activities that put repetitive pressure on the neuroma should be avoided until the condition improves.

Medications. Nonsteroidal antilnflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation.

Icing. Placing an ipecac on the affected area helps reduce swelling.

Injection therapy. If there is no significant improvement after initial treatment, injection therapy may be tried.
Since 2001 we have been treating Neuromas with a series of alcohol injections. The nerve tissue has an affinity to alcohol. In 86% of cases, neuroma pain can be almost completely eliminated over a 7-9 week injection series.

Orthotic devices. Custom orthotic devices provided by your podiatric surgeon provide the support needed to reduce pressure and compression on the nerve.

When Is Surgery Needed?
Surgery may be considered in patients who have not received adequate relief from other treatments. Generally, there are two surgical approaches to treating a neuroma- the effected nerve is either removed or released. Your podiatric surgeon will determine which approach is best for your condition. The length of the recovery period will very, depending on the procedure or procedures performed. Regardless of whether you've undergone surgical or non surgical treatment, your podiatric surgeon will recommend long-term measures to help keep your symptoms from returning. These Include appropriate footwear and modification of activities that cause repetitive pressure on the foot.