A neuroma is thickening of tissue surrounding a nerve. The most common location in the foot occurs between the 3rd and 4th toes. Although the name "neuroma" suggests a tumor of the nerve, this condition is not a tumor, rather thickening of the tissue surrounding the nerve, also called perineural fibrosis.
Diagnosis of a neuroma is not always an easy task, as there are several other conditions that may cause similar pain in the ball of the foot. Conditions such as stress fractures, capsulitis, arthritis, and metatarsalgia must be ruled out.
In most cases, the proper diagnosis can be made through a proper medical history and physical exam. X-ray examination is standard to help make the diagnosis, and diagnostic ultrasound can be beneficial, as well. MRI is rarely needed to establish a diagnosis, but it can be helpful if the condition does not respond favorably to standard treatments.
Initially, non-surgical treatments are pursued in a effort to avoid surgery. Each person responds to non-surgical treatments differently, and it is difficult to predict the success of these treatments. One person may respond favorably to injection therapy and padding, while the next patient may require custom orthotics or surgery to relieve the symptoms. The best way to optimize success is to establish, and continually confirm, an accurate diagnosis.
Non-surgical Treatments Include:
- Activity or shoe modifications
- Custom Orthotics
- Injection Therapy
Symptoms of Neuroma:
- Pain in the ball of the foot
- Tingling, Burning, or Numbness into toes
- Feeling like you are "stepping on a pebble"
Surgery is considered if non-surgical treatments have failed, or physical demands require an immediate solution. Generally, a 2-3 inch incision is placed on the top of the foot. The nerve is identified and removed. Stitches are usually placed beneath the skin, utilizing plastic surgery techniques, which allow for minimal scar formation and no painful removal of stitches. Patients are normally allowed to walk in a boot or surgical shoe for 2-3 weeks, and then back into tennis shoes. Many patients return to pre-operative activity levels between 3 and 6 weeks.
After surgically removing a neuroma, there is a chance the nerve tissue can grow back. The reported recurrence rate for a neuroma is 10-15%. Dr. McSpadden has successful experience in treating these recurrent neuromas, and he utilizes surgical techniques that help minimize the chance of recurrence.
If you would like to learn more about Morton's Neuroma, Call 512-593-2949 or CLICK HERE to Schedule an Appointment.