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Neuroma Treatment

Neuroma Treatment

A neuroma is a growth or tumor that occurs in nerve tissue. Most of them are benign.

Morton’s Neuroma is called a metatarsal neuroma. It is characterized by inflammation, tissue thickening, enlargement of the nerve between the metatarsal bones, most commonly the third and fourth toes. The root cause remains unknown, but proper footwear helps alleviate symptoms.

This occurs when the nerve becomes squeezed or irritated by the metatarsal bones.

If left untreated, the neuroma can cause sharp, burning and shooting pain that worsens over time. Treatment varies depending on the severity of symptoms and the cause of the neuroma.

 

Diagnosis begins with:

  • Doctors exam
  • x-rays
  • possibly MRI
  • Electromyelogram

 

Symptoms include the following and should be reported to the doctor:

  • Sharp or stinging pain between toes when standing or walking.
  • Pain in the forefoot
  • Swelling between toes.
  • Tingling (“pins and needles”)
  • Feeling of a “bunched-up sock,”  pebble, or marble under the ball of the foot.

Not everyone has pain and discomfort.

Doctors use a gradual treatment plan and begin with conservative and home treatment before proceeding with more intensive and invasive procedures.

 

Conservative treatment begins with:

  • arch supports or foot pads in shoes
  • OTC anti-inflammatory pain medicines like ibuprofen or aspirin
  • physical therapy
  • stretching exercises
  • massage
  • resting
  • ice application to the sore area(s)

 

Injections are somewhat conservative and provide temporary relief of pain. If pain continues or gets worse, corticosteroids or anti-inflammatory drugs may be injected into the painful area. Local anesthesia may be used to numb the affected nerve.

 

Surgery is a more aggressive treatment used when all else has failed to bring relief.

Surgical options may include:

  • neurectomy (part of the nerve is removed)
  • cryogenic surgery/cryogenic neuroablation (nerves and the myelin sheath are killed using extreme cold )
  • decompression surgery (pressure on the nerve is relieved by cutting ligaments and/or other structures surrounding the nerve)

Recovery from any of these procedures varies and is dependent on the severity of the neuroma and procedure chosen.

 

One of the easiest ways to prevent recurrence  is to wear the proper shoes and:

  • Avoid tight-fitting shoes
  • Avoid wearing high heels for long periods
  • Choose shoes with a wide toe box that allows wiggling of toes.
  • If the doctor recommends it – wear orthotic insert to relieve pressure on ball of the foot.
  • Wear padded socks
  • Wear footwear that protects the feet during athletic activities
  • Get an anti-fatigue mat for jobs or activities that require standing for long periods
  • Physical therapist for a routine of stretches and exercises will help to strengthen your legs and ankles.

 

What are the symptoms of Morton’s neuroma?

  • A sharp or stinging pain between the toes when standing or walking.
  • Pain in the forefoot between the toes.
  • Swelling between the toes.
  • Tingling (“pins and needles”) and numbness.
  • Feeling like there is a “bunched-up sock” or a pebble or marble under the ball of the foot.
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