Neuroma Symptoms Diagnosis and Treatment Options

Persistent pain in the feet or other parts of the body can sometimes be traced back to a condition called neuroma. This condition involves irritation of a nerve due to perineural fibrosis, which can cause ongoing discomfort and affect daily activities. Understanding what a neuroma is, how it presents, and the available treatment options can help those affected find relief and improve their quality of life.

Close-up view of a foot showing a swollen nerve sections - Neuroma

Close-up view of a foot showing a swollen nerve sections - Neuroma

What Is a Neuroma?

A neuroma is a thickening of nerve tissue that develops as a result of irritation or injury. Specifically, it is a form of perineural fibrosis, which means scar tissue forms around a nerve. This scar tissue can compress or irritate the nerve, leading to persistent pain, tingling, or numbness.

One of the most common types is the Morton’s neuroma, which affects the nerves between the toes, usually between the third and fourth toes. However, neuromas can develop in other parts of the body where nerves are compressed or irritated.

The key feature of a neuroma is that it is not a tumor but rather a benign growth of nerve tissue caused by chronic irritation. This distinction is important for understanding treatment and prognosis.

Symptoms of Neuroma

Neuroma symptoms often develop gradually and can vary in intensity. Common signs include:

• Sharp, burning pain in the affected area, often described as shooting or stabbing.

• Tingling or numbness that may radiate into the toes or fingers, depending on the location.

• A feeling of a lump or something inside the foot, especially when walking or standing.

• Increased pain with activity such as walking, running, or wearing tight shoes.

• Relief when resting or removing footwear that compresses the area.

  
  

For example, someone with Morton’s neuroma might feel like they are standing on a pebble inside their shoe, and the pain worsens with pressure.

How Neuroma Is Diagnosed

Diagnosing a neuroma involves a combination of clinical evaluation and imaging tests:

Clinical Examination

A healthcare provider will:

• Ask about symptoms and their onset.

• Perform a physical exam, including palpation of the affected area.

• Use specific maneuvers such as squeezing the foot to reproduce symptoms.

• Check for sensory changes or weakness.

  
  

Imaging Tests

Imaging helps confirm the diagnosis and rule out other causes:

• Ultrasound is commonly used to visualize the thickened nerve and surrounding tissue.

• MRI can provide detailed images of soft tissues and detect neuromas.

• X-rays may be done to exclude bone problems but do not show neuromas.

  
  

Diagnostic Nerve Blocks

Sometimes, a local anesthetic injection near the suspected nerve can help confirm the diagnosis if the pain temporarily disappears.

Conservative Treatment Options

Many neuromas respond well to non-surgical treatments, especially when diagnosed early. These options focus on reducing nerve irritation and managing symptoms.

Footwear Modifications

• Wearing shoes with a wide toe box to reduce pressure on the nerve.

• Avoiding high heels or tight shoes that compress the forefoot.

• Using orthotic inserts or pads to redistribute weight and relieve pressure.

  
  

Activity Changes

• Reducing activities that worsen symptoms, such as running or prolonged standing.

• Incorporating rest periods allows inflammation to decrease.

  
  

Medications

• Over-the-counter pain relievers like ibuprofen or acetaminophen can reduce pain and inflammation.

• In some cases, doctors may prescribe neuropathic pain medications such as gabapentin.

  
  

Physical Therapy

• Stretching and strengthening exercises to improve foot mechanics.

• Techniques like ultrasound therapy or massage may help reduce symptoms.

  
  

Injections

• Corticosteroid injections near the nerve can reduce inflammation and pain.

• Some providers use alcohol or phenol injections to chemically ablate the nerve, though this is less common.

  
  

When Surgery Is Needed

If conservative treatments fail to provide relief after several months, surgery may be considered. Surgery aims to remove the neuroma or release the nerve from surrounding tissue.

Surgical Options

• Neurectomy involves removing the affected portion of the nerve. This can provide lasting pain relief but may cause permanent numbness in the area supplied by the nerve.

• Decompression surgery relieves nerve compression by cutting surrounding ligaments or tissues, thereby preserving nerve function.

  
  

Recovery and Outcomes

• Surgery usually requires a period of rest and limited weight-bearing.

• Physical therapy may be needed to regain strength and mobility.

• Most patients experience significant pain relief, but some may have residual numbness or discomfort.

  
  

Living with Neuroma: Practical Tips

• Choose comfortable, supportive footwear daily.

• Avoid repetitive activities that put pressure on the affected nerve.

• Use ice packs to reduce swelling after activity.

• Monitor symptoms and seek medical advice if pain worsens or changes.

  
  

Persistent pain from a neuroma can disrupt daily life, but understanding the condition and treatment options helps people take control of their health. Early diagnosis and appropriate care often lead to good outcomes, whether through conservative measures or surgery.

If you experience ongoing foot pain or tingling, consult a healthcare provider for a thorough evaluation. Effective management of a neuroma can restore comfort and keep you moving without pain.

Ready to make an appointment? Call 832-743-0508 or schedule online at www.SelectFAS.com.