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Neuroma
A neuroma is an inflamed nerve in the ball of the foot. A patient with a neuroma will feel burning, cramping, numbness or sharp pain in the ball during standing and walking. Sometimes pain or numbness radiates into the toes.
A neuroma develops when a nerve on the bottom of the foot becomes trapped or pinched between the skin and underlying ligaments or bone. It happens on the ball because that is where most pressure occurs as the foot propels the body forward. Over time, the nerve enlarges, and forms an actual mass (see photo) that can be palpated by the doctor.
Initial TreatmentShoes should be chosen that are wide and roomy in the toe box. This takes pressure off the nerve. Shoes that are soft and cushioned under the ball are also helpful.
Podiatrists usually inject the tissue around the nerve with a mixture of cortisone and local anesthetic. The foot is then taped in a manner that takes pressure off the nerve. If this helps, orthotics (custom supports) can be made to similarly take pressure off the painful area.
Neurolytic Injection TherapyThe doctors of the North Shore podiatry Group have extensive experience with a new treatment that in most cases reduces or eliminates the neuroma without surgery. The doctor injects a small amount of an alcohol/local anesthetic solution around the nerve. Injections are given at two-week intervals. Most patients report improvement after two injections, with resolution of the neuroma pain after five to seven.
SurgeryIn rare instances, conservative and neurolytic therapy do not resolve the neuroma. In that case excision of the neuroma (see photo) is performed on an outpatient basis under local anesthesia and twilight sedation.
If you have questions or would like to discuss the treatment of neuromas, please contact The North Shore Podiatry Group..
The North Shore Podiatry Group
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