If you’re anything like us, you absolutely can’t stand the feeling of something trapped in your shoe or pressing on your foot. This could be something like a blister, or stepping on a pebble or LEGO brick, or even something as simple as an uncomfortable bunch in your sock.
A neuroma on the ball of your foot is kind of like this experience, only all the time. You can’t simply flick it away, because it’s located deep under your skin. You may not be able to see it or feel a bump, but it’s there, pressing on your nerve.
Description and Symptoms of a Morton’s Neuroma
Also known as a “nerve tumor,” a neuroma is a benign (that is, non-cancerous) growth of tissue on or around a nerve. A Morton’s neuroma, the most common type we see, most affects a plantar nerve and is located in the space between the third and fourth (or occasionally second and third) toes. Those thickened tissues then press uncomfortably against the nerve, often when walking or bearing weight.
Symptoms can vary quite a bit, depending on your specific case. For some, it’s only a minor irritant, like a fold in a sock; others feel like they’re walking on razor blades with every step. Swelling, burning, or tingling sensations are also common.
Why Do “Nerve Tumors” Happen?
Unfortunately, we don’t really know for sure. Most cases, though, can generally be traced to a source of repetitive irritation of the forefoot. This could include anything from repetitive activities from a hobby or occupation, to wearing shoes that don’t fit correctly or support your foot effectively, to pressures from an existing foot deformity like a bunion or flat feet.
Another potential cause is trauma from a specific injury. Women tend to get Morton’s neuroma much more frequently than men, by a factor of almost 10.
Conservative Treatment Options
Fortunately, many cases of Morton’s neuroma can be effectively managed without needing the knife. However, you need to be proactive—Morton’s neuroma is a progressive condition, which means the earlier you take action, the better your odds are of achieving satisfying results through simple solutions.
In the best-case scenario, a commitment to better shoes might be all you need. Go for styles with lots of wiggle room for toes, low heels, support for the arch, shock absorption, and adjustable laces. Definitely avoid heels, especially those greater than 2 inches.
To help manage pain flare-ups, you can use ice, massage, OTC anti-inflammatory medication, or just a little old-fashioned rest; more intense pain might require an alcohol injection to reduce symptoms. Shoe inserts like metatarsal pads, arch supports, or toe spacers can also help relieve excess pressure on the nerve.
If you have any underlying structural defects contributing to the development of a neuroma, such as flat feet or high arches, these may also be addressed with tools such as custom orthotics.
Surgery is considered a last resort, only when gentler therapies fail. The specific procedure selected will depend on the specifics of your case. Decompression surgery involves cutting nearby structures (such as ligaments) to relieve pressure, or excising the tissue growth entirely. While surgery is highly successful on average, there are always some risks, including the possibility of permanent numbness in the affected toes.
Whether you need surgery or not, Massapequa Podiatry Associates can help you find the right solution for relieving your Morton’s neuroma pain and halting the progression of the condition as much as possible. To schedule a visit with Dr. Corey Fox at our Nassau County office, book online or call at (516) 541-9000.