A popular complaint amongst patients seen in our office is the feeling that they are “walking on a marble or pebble.” This is often due to a persistent pain in the ball of the foot that lingers with each step.
A neuroma is defined as a benign tumor of a nerve. However, the definition is misleading. The condition is not actually a tumor but rather a thickening of the surrounding tissue causing irritation to the nerve and associated of dull, achy pain with possible burning & tingling to the digits. It is often referred to a pinched nerve.
Women are more prone to the condition due to the use of high heel shoes causing direct pressure to the ball of the foot to the nerve, resulting in the symptoms. The most common neuroma is the “Morton’s Neuroma” located in a space behind the 3rd and 4th toes.
HOW A NEUROMA IS FORMED
Each toe has a long bone located directly behind called a metatarsal. In between each metatarsal, nerves pass under the ligaments connecting the long bones. A neuroma forms when the surrounding tissue of each nerve is irritated. This most commonly occurs when the metatarsals squeeze or compress the nerve, thus explaining the term “pinched nerve.” Common causes for this compression include trauma, tight shoes, high heels, and excessive pressure.
- Pain in the ball of the foot while walking, relieved with rest
- Burning and tingling pain radiating to the digit
- Numbness of toes
- Feels like “walking on a marble or pebble” or “rolled up sock”
- Diverging toes showing a “peace sign”
X-rays are important tools to help in the diagnosis of a neuroma. They provide valuable information on the shape of each metatarsal as well as rule out any other possible conditions..
A neuroma can successfully healed using conservative treatment options:
- Wider shoes with lower heels and a soft sole
- Orthotic with specific modifications to splay the metatarsals and reduce pressure on the nerve
- Corticosteroid or Alcohol based injections
- Prescription anti-inflammatories or steroids.
At Premier Foot & Ankle, we’re proud to offer an advanced and new conservative option called Podiatherm to treat neuromas. The treatment involves a sterile procedure where the affected nerve is cauterized. The effects and recovery period are instant with virtually no side effects. This is a great option if surgery is to be avoided!
When all conservative options fail, surgery is the next choice. The procedure of choice is typically the removal of the nerve and its associated branches. Fortunately, this procedure has a very quick recovery phase and performed on an outpatient basis. Most patient are able to walk within days after surgery!
If you are exhibiting early indication of pain or discomfort, visit your podiatrist at Premier Foot & Ankle for care!