A neuroma is a swollen or damaged nerve. This often occurs between the bones that your toes attach to on the foot, most commonly between the third and fourth toes. Neuroma can be caused by tight shoes, repetitive stress or trauma.
The most common symptoms of neuromas are cramping, tingling, or numbness. Sometimes these symptoms can go from the ball of the foot to the toes or from the ball of the foot to the ankle. Feeling like a sock is bunched up can also be a sign of a neuroma. Tight shoes usually aggravate symptoms. However, any kind of bending of the toes or stepping the wrong way when barefoot can also cause the same symptoms. If the neuroma becomes large enough, it may cause a clicking sensation or a lump in the ball of the foot.
Podiatrists use sonography of the foot to confirm the diagnosis and to aid in the location of the nerve damage so that treatment can be directed at the exact location of trouble. Early treatments include:
• Roomier or specially constructed shoes
• Orthotics (inserts) for the shoes
• Anti-inflammatory medicines
• Cortisone injections
• Alcohol sclerosing injections
If these methods fail, then surgery may be suggested to remove damaged nerve tissue. However, we have been using dehydrated alcohol injected into the nerve (with ultrasonic guidance when indicated) to chemically destroy the nerve without surgery.
More on pinched nerves in the foot
Contributed by Gene Mirkin, DPM