A neuroma is a thickening of nerve tissue that may develop in various parts of the body. The most common type of neuroma on the foot is called ‘Morton’s neuroma’ which occurs at the base of the third and fourth toes. It is also called an intermetatarsal neuroma. An intermetatarsal neuroma can occur between any of the toes. The term ‘intermetatarsal’ describes the location in the ball of the foot between the metatarsal bones. The foot has five metatarsal bones. Neuromas can also occur in other areas of the foot.

The thickening or enlargement of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates swelling of the nerve, eventually leading to permanent nerve damage.

Symptoms of an intermetatarsal neuroma involve pain, burning, tingling or numbness between the affected toes. A common complaint among patients is a feeling that something is inside the foot or the sock is bunched up inside the shoe. The progression of a neuroma usually follows a pattern where symptoms begin gradually with pain or numbness happening only occasionally. Over time the pain, numbness, burning or tingling become more intense or frequent. If pain progresses to happen at rest or night this often means the neuroma has significantly worsened.

What causes a neuroma? Anything that compresses the nerve can lead to a neuroma. One of the most common offenders is wearing shoes that have a tapered toe box. High heeled shoes for women often exacerbate the problem. Frequent use of elliptical trainers at health clubs can also cause compression on the nerve and this is also known as "elliptical trainer sleepy foot syndrome". People with bunions that widen the foot also have a higher chance of developing a neuroma. Athletes that engage in repetitive stress to their feet can also cause a neuroma to develop. An intermetatarsal neuroma is a very common problem and treatment focuses on relieving the pain.

Early on this may involve modifying shoes or activities. Arch supports or ‘orthotics’ can often help as well. Frequently a podiatrist may inject the area to calm the inflamed nerve down and this may relieve pain for weeks, months or permanently. It is important to also have the patient wear proper shoes and use arch supports to reduce stress to the ball of the foot and improve mechanics. When a neuroma becomes debilitating and chronic, the podiatric surgeon may discuss surgery for removal or decompression of the nerve involved. Recovery times vary but often a patient can be active again in athletic activities after four weeks.

Call for an appointment if you are having symptoms of a ‘neuroma’.