A neuroma is a benign overgrowth or thickening of nerve tissue, sometimes referred to as a nerve “tumor.” In podiatry, the most common type of neuromas is Morton’s neuroma, which develops in the ball of the foot (the fleshy portion of the foot below the base of the toes), typically between the third and fourth toes. Neuromas form when a nerve becomes irritated and inflamed; over time, recurrent irritation and pressure causes the tissue to become thick and painful. Neuromas occur most commonly among people who wear shoes that are tight in the toe area or otherwise restrictive or ill-fitting, resulting in increased pressure in one area of the foot. Repetitive stress or impact can also result in neuroma formation, and so can traumatic injury. Neuromas also may be more common among people with specific foot shapes or gait patterns.
Neuromas can cause an array of symptoms, including:
Symptoms can vary in intensity from one person to another, and without proper treatment, they tend to become worse over time. Seeing a podiatrist at the first sign of symptoms is important for preventing the condition from worsening.
Diagnosis can usually be accomplished with a physical exam and a review of the patient’s symptoms and lifestyle habits. In a few cases, diagnostic imaging may be ordered to rule out other possible issues and to evaluate the extent of the damage. Neuromas that cause very mild symptoms can sometimes be treated by changing shoe styles to one that offers more room in the toe area, and gentle stretching of the foot and toes can also help. Many patients benefit from custom orthotics, which can be very useful in relieving pressures on the affected area of the foot so nerve irritation and inflammation can be relieved. Oral medications can also be used to help reduce inflammation, and in some cases, corticosteroid injections may prove useful. Rarely, surgical intervention may be needed.
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