In this section Cypress Foot and Ankle specialist Dr. Christopher Correa discusses ball of foot pain caused by neuromas. A Neuroma is a swollen nerve surrounded by scar tissue in the ball of the foot. The most commonly affected nerves are the plantar common digital nerves which supply sensation to the web space between the toes. Neuromas are usually caused by impingement of one of the nerves as it passes under the deep transverse metatarsal ligament, a supporting ligament that links the metatarsal heads together. Major factors contributing to this impingement include tight fitting shoes, localized trauma, unsupportive shoes, prolonged standing on toes or ball of foot, high arched feet and hammer toes.
Symptoms of Neuromas
Common neuroma symptoms typically involve any combination of the following:
· Pain – “electrical, burning, stabbing, tingling” or general feeling of discomfort or “fullness” underneath the toes.
· Pain may radiate to a large area.
· Numbness of the adjacent toes.
· Shooting or electric sensation that may travel down to the toes or into the arch of the foot or the sensation of “walking on a rock or pebble”.
Symptoms are most commonly described as intermittent episodes of pain in the ball of the foot that may radiate to the toes, top of the foot or to the ankle. It may feel like a marble or stone on the ball of the foot and is personified by burning, tingling, or cramping. Occasionally patients relate a feeling of “fullness” in their foot. Oftentimes these symptoms are intensified with activity and relieved by avoiding tight fitting shoes and rest. A common sign of nerve pain is one that lingers for 10 minutes or so after the patient has gotten off of their feet. Usually, neuromas affect just one interspace in one foot but may occur in m multiple. The most common location for neuromas to form is between the third and fourth toes and is known as a Morton’s neuroma.
Treatment of Neuromas
Conservative treatments for neuromas involve a combination of anti-inflammatory medications, steroid injections and shoe gear modifications. Orthotics can help correct the underlying structural deformity or accommodate the neuroma and help take pressure off the nerve. The goal of treatment is to reduce the pressure and inflammation around the nerve. If symptoms do not resolve with conservative care then either destruction or removal of the nerve may then be necessary. Chronic, prolonged symptoms lead to swelling and scar tissue formation around the nerve. This added scar tissue increases the diameter of the nerve increasing the overall irritation at this site. Excessive scarring cause by long standing neuroma can make the symptoms increasingly persistent making it difficult to find relief. While reduction of inflammation is usually achievable, the scaring around the nerve usually persists. This leads to increased risk of re aggravation of the neuroma. If caught early however the symptoms usually go away and stay away. If you have pain in the ball of your foot give the experts at Select Foot and Ankle Specialists a call and take the first step towards recovery today.
