Neuroma

Medical Terminology: neuroma or neuritis

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What is a neuroma?

A neuroma is a small mass made up of nerve cells and nerve fibers that may develop in various parts of the body.  A neuroma can be described as a thickened nerve. The most common neuroma that occurs in the foot is Morton’s neuroma, which is in between the third and fourth toe. A neuroma can occur in between any two toes and multiple neuromas could be found in one foot or in both feet. Although it is commonly referred to as a neuroma, which is a benign tumor, the more accurate term to use is a neuritis which indicates inflammation within the nerve.

What causes a neuroma?

Whether it is a true neuroma (a benign tumor of nerve cells) or more commonly neuritis (inflammation of the nerve) the most common cause is compression or irritation of the nerve. Compression or irritation of the nerve can be caused by:

• Narrow or tight fitting shoes.
• High heels that force the toes in a cramped position.
• Bony deformities, such as bunions or hammer toes.
• Flat feet or flexible feet.
• Over-pronation.
• Over training or high impact sports/activities.
• Trauma or injury to the area.

What are the symptoms of a neuroma?

• Pain under the ball of your foot.
• Burning or tingling sensations.
• Numbness.
• Feeling like you’re stepping on a pebble.
• Feeling like there is something in your shoe or sock.

Symptoms may temporarily disappear by:

• Removing shoes.
• Massaging feet.
• Avoiding ill-fitting footwear or aggravating activities.

How do I know I have a neuroma?

A foot specialist, chiropodist or podiatrist, will gather a thorough patient history of symptoms as well as perform a physical exam of your foot. By physically manipulating the foot, the foot specialist will attempt to reproduce the symptoms of a neuroma. Further tests or imaging studies may be requested through your family physician.

What is the treatment for a neuroma?

Most neuromas will respond to conservative, non-surgical treatment. The will develop a unique treatment plan for your neuroma based on the symptoms present and the severity of the problem.

Conservative treatments may consist of:

• Padding.
• Certain pads may help offload the problematic area allowing less pressure on the neuroma and reducing the symptoms.
• Custom-made orthotics.
• Support for the foot by redistributing pressure or realigning foot joints.
• Incorporate padding into the orthotic to reduce pressure in the foot and reduce stress on the nerve.
• Proper fitting footwear.
• Wide toe box allowing enough room for toes.
• Avoiding narrow shoes and high heels.
• Medications.
• Oral nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen and naproxen, may help reduce pain and inflammation.
• Injection therapy.
• Steroid injections to reduce pain and inflammation.
• Alcohol sclerosing injections to reduce the size of the neuroma.

If the neuroma does not respond to conservative treatments, a surgical approach may be recommended to reduce symptoms.  There are surgical treatment options that can be discussed with your foot specialist. The Mississauga Foot Clinic is fully equipped to perform in-office surgical treatment for your neuroma.

Whether the treatment for the neuroma was conservative or surgical, it is important to use proper fitting footwear or avoid certain activities to prevent the reoccurrence of a neuroma in the future.