Neuroma
A neuroma is a benign, non-cancerous condition where a nerve enlarges and produces pain. In the foot the most common place to develop a neuroma is at the ball of the foot between the metatarsal heads. Symptoms include burning, shooting and pins and needles (parathesia) into the associated toes. The pain is often relieved by removal of the shoe and rubbing the affected area.
The Most Common Neuroma
In the foot the most common neuroma is a Morton’s neuroma and is present between the third and fourth metatarsal heads (ball of the foot) and sends nerve pain into the third and fourth toes. Neuromas can develop between the adjacent metatarsal heads but a Morton’s neuroma is the most common.
Non-surgical treatment for a neuroma includes:
- Calf stretching exercises
- Footwear alteration
- Insoles
- Steroid injections
If non-surgical management fails to alleviate the pain surgery may be required.
Surgery includes either:
- Cutting the ligament above the neuroma to reduce pressure onto the nerve, much the same as a carpel tunnel release
- Excision of the nerve (neurectomy).
Depending on the size of the neuroma cutting of ligament above the neuroma may be indicated as this can be done through a minimally invasive technique (key hole surgery). A video of this technique can be viewed by clicking on the link below:
http://www.osteomed.com/SBO_Lower/KobyGard.aspx – (this link contains a video of live surgery – caution advised)
For more information about neuromas please click on the link below:
http://www.aofas.org/footcaremd/conditions/ailments-of-the-big-toe/Pages/Mortons-Neuroma.aspx