A neuroma is a painful condition, also referred to as a “pinched nerve” or a nerve tumor. It is a benign growth of nerve tissue frequently found between the third and fourth toes that brings on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot.

The principle symptom associated with a neuroma is pain between the toes while walking. Those suffering from the condition often find relief by stopping their walk, taking off their shoe, and rubbing the affected area. At times, the patient will describe the pain as similar to having a stone in his or her shoe. The vast majority of people who develop neuromas are women, often due to high-heels and tight-fitting shoe gear.

Symptoms include pain in the forefoot and between the toes, tingling and numbness in the ball of the foot, or pain in the ball of the foot when weight is placed on it. There is occasionally swelling between the toes as well.

Causes

• Poor foot alignment
• Trauma
• Improper footwear
• Repetitive stress such as prolonged walking or standing

Prevention

• Wear shoes with plenty of room for the toes to move, low heels, and laces or buckles that allow for width adjustment.
• Wear shoes with thick, shock-absorbent soles and proper insoles that are designed to keep excessive pressure off of the foot.
• High heels should be avoided whenever possible because they place undo strain on the forefoot and can contribute to a number of foot problems.
• Resting the foot and massaging the affected area can temporarily alleviate neuroma pain. Use an ice pack to help to dull the pain and improve comfort.

Treatment

Options vary with the severity of each neuroma, and identifying the neuroma early in its development is important to avoid surgical correction. Podiatric medical care should be sought at the first sign of pain or discomfort. If left untreated, neuromas tend to get worse.

The primary goal of most early treatment regimens is to relieve pressure on areas where a neuroma develops.

• Padding and Taping – special padding at the ball of the foot may change the abnormal foot function and relive the symptoms caused by the neuroma
• Medication – anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the neuroma
• Orthotic Device – custom shoe inserts may be useful in controlling foot function and off-loading the painful area of the foot
• Surgery – when early treatments fail and the neuroma progresses past the threshold for such options, surgery is indicated which consists of removing the inflamed and enlarged nerve on an out-patient basis