The most common neuroma that we treat in the foot and ankle is called a Morton’s Neuroma – a specific condition that occurs in the ball of the foot. Neuromas are a term that is applicable for any damaged nerve in the foot and ankle that contains an abnormal or anatomical variance. This occurs because of some level of trauma and causes the nerve to inflame larger than those surrounding it. Even though these nerves are damaged and cause varying levels of pain throughout the foot, they are still in continuity, so the structure is still intact.
Normally, there are no outward signs, such as a lump, because the nerve is deep within the foot. Most patients experience some numbness, tingling, burning, and oftentimes feel like there’s a marble or an extra pebble in the ball of the foot. The single most common symptom is a burning sensation that radiates into the toes without proper footwear. High-heeled shoes put the foot in a similar position to that of a runner off of the starting block, which aggravates the condition. On the other hand, tight, narrow shoes irritate the foot by compressing the toe bones and pinching the nerve.
Neuromas occur much more commonly between the third and fourth toes. For example, in women, the nerve gets pushed together because of particularly narrow and constructive shoewear. Ultimately, this leads to a vicious cycle of the nerve becoming swollen from trying to fit in a very small “tunneled” area. This causes the nerve to receive more friction and increases pain and discomfort. When foot pain gradually increases and medical assistance is needed, an examination usually reveals a mass that can be felt between the toes and a “click” may occur when pressure is applied between the bones.
The way we treat the condition is taking pressure off of the nerve. This is done by creating an appropriate shoewear modification, specifically a wider shoe that prevents bones from pinching. Other conservative treatments are also utilized such as cortisone injections to decrease inflammation. In certain scenarios we perform surgical interventions to decrease the pressure around the nerves.
If conservative treatment does not relieve symptoms, surgery may be considered. This specifically involves resecting a small portion of the nerve and releasing the tissue and ligaments overlying the nerve. This outpatient procedure can be performed under ankle block anesthetic (local anesthetic) and involves two weeks in a rigid orthopedic shoe with immediate weight bearing. Transition to a regular shoe occurs as soon as swelling allows.
When we walk, all pressure is transferred to the feet. It’s these two crucial appendages that support the body and allow for all acts of motion to occur. A Morton’s neuroma can seriously affect the ability to efficiently bear weight and makes walking without pain incredibly difficult. For the best neuroma treatment in Illinois, consider the professional assistance from Dr. Anand Vora. His orthopedic expertise on the foot allows him to diagnose and treat patients with the utmost care. To explore neuroma relief options and compassionate support, please contact Dr. Vora today to schedule your appointment.