Normal 0 false false false EN-US X-NONE X-NONE
Mortons Neuroma - Podiatrist in Newburyport and Chelmsford, MA
http://www.nefootankle.com
What is a Neuroma?
A neuroma is a painful condition, also referred to as a “pinched nerve” or a nerve tumor. It is a benign growth of nerve tissue frequently found between the third and fourth toes that brings on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot.
The principle symptom associated with a neuroma is pain between the toes while walking. Those suffering from the condition often find relief by stopping their walk, taking off their shoe, and rubbing the affected area. At times, the patient will describe the pain as similar to having a stone in his or her shoe. The vast majority of people who develop neuromas are women.
Symptoms
- Pain in the forefoot and between the toes.
- Tingling and numbness in the ball of the foot.
- Swelling between the toes.
- Pain in the ball of the foot when weight is placed on it.
How Do You Get a Neuroma?
Although the exact cause for this condition is unclear, a number of factors can contribute to the formation of a neuroma.
Biomechanical deformities, such as a high-arched foot or a flat foot, can lead to the formation of a neuroma. These foot types bring on instability around the toe joints, leading to the development of the condition.
Trauma can cause damage to the nerve, resulting in inflammation or swelling of the nerve.
Improper footwear that causes the toes to be squeezed together are problematic. Avoid high-heeled shoes higher than two inches. Shoes at this height can increase pressure on the forefoot area.
Repeated stress, common to many occupations, can create or aggravate a neuroma.
What Can You Do for Relief?
- Wear shoes with plenty of room for the toes to move, low heels, and laces or buckles that allow for width adjustment.
- Wear shoes with thick, shock-absorbent soles and proper insoles that are designed to keep excessive pressure off of the foot.
- High heels should be avoided whenever possible because they place undo strain on the forefoot and can contribute to a number of foot problems.
- Resting the foot and massaging the affected area can temporarily alleviate neuroma pain. Use an ice pack to help to dull the pain and improve comfort.
- For simple, undeveloped neuromas, a pair of thick-soled shoes with a wide toe box is often adequate treatment to relieve symptoms, allowing the condition to diminish on its own. For more severe conditions, however, podiatric medical treatment or surgery may be necessary to remove the tumor.
- Use over-the-counter shoe pads. These pads can relieve pressure around the affected area.
Treatment by Your Podiatric Physician
Treatment options vary with the severity of each neuroma, and identifying the neuroma early in its development is important to avoid surgical correction. Podiatric medical care should be sought at the first sign of pain or discomfort; if left untreated, neuromas tend to get worse.
The primary goal of most early treatment regimens is to relieve pressure on areas where a neuroma develops. Your podiatric physician will examine and likely X-ray the affected area and suggest a treatment plan that best suits your individual case.
Padding and Taping:
Special padding at the ball of the foot may change the abnormal foot function and relive the symptoms caused by the neuroma.
Medication:
Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the neuroma.
Orthotic Devices:
Custom shoe inserts made by your podiatrist may be useful in controlling foot function. An orthotic device may reduce symptoms and prevent the worsening of the condition.
Surgical Options:
When early treatments fail and the neuroma progresses past the threshold for such options, podiatric surgery may become necessary. The procedure, which removes the inflamed and enlarged nerve, can usually be conducted on an outpatient basis, with a recovery time that is often just a few weeks. Your podiatric physician will thoroughly describe the surgical procedures to be used and the results you can expect. Any pain following surgery is easily managed with medications prescribed by your podiatrist.
Your Feet Aren’t Supposed to Hurt
Remember that foot pain is not normal, and any disruption in foot function limits your freedom and mobility. It is important to schedule an appointment with your podiatrist at the first sign of pain or discomfort in your feet, and follow proper maintenance guidelines to ensure their proper health for the rest of your life. The advice in this pamphlet should not be used as a substitute for a consultation or evaluation by a podiatric physician.
A New Neuroma Treatment called Sclerosing Injection Therapy
Morton's Neuroma
This condition was first described by T. G. Morton in 1876. He used the more vague terminology of "metatarsalgia" to describe a painful condition in the ball of the foot. Pain is caused by pressure on the digital nerves as they pass between the heads of the metatarsal bones, most commonly between the third and fourth toes, and secondarily between the second and third toes. Patients often feel cramping, tingling or burning and occasionally shooting pains in their forefoot or toes. Many feel the need to remove their shoe to massage the painful area.
Sclerosing Injection Therapy
Surgical excision (neurectomy) to remove a neuroma is frequently done when cortisone injections, foot inserts and anti-inflammatory medication fail. However, surgery should be considered as a last option due to the associated risks such as infection, scar tissue or recurrence. Sclerosing (sometimes called alcohol surgery) can be a wonderful alternative to surgical excision. Alcohol hampers the nerve's ability to transmit painful impulses. Alcohol injections affect the nerve by causing a "short circuit", desensitizing the painful area with mild numbness. This is exactly the same result that we aim for with surgery!
Sclerosing therapy can be done in the office and often produces the same level of relief without the risks associated with surgery. More importantly, there are no restrictions on activity after the injections, as there would be with surgery. Patients can expect good results, as success rates are between 70-80%. In rare cases where the therapy was not successful, surgery is still an option.
Neuroma sclerosis requires a series of weekly injections. After 3 injections, pre-treatment symptoms are reevaluated. If no improvement is noted, the series will be discontinued. However, if some improvement is noted, then the series will be completed, up to a total of 7 injections.
Note: Because injections have been given a "surgery code" by insurance companies, it will appear on your Explanation of Benefits as a surgery, even though you never approached an operating room.
Visit our website: http://www.nefootankle.com
