A neuroma is a disorganized and scarred bundle of nerve fibers that can develop along the course of any nerve. They can be caused by direct trauma or from compression of surrounding tissue.
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This is a classic neuroma that develops between the 3rd and 4th knuckle of the foot. Typical symptoms include pain in the ball of the foot, sensation of a balled sock, or tingling and/or numbness to the toes. The symptoms often occur after wearing a shoe for a short period of time, but can also present when walking barefoot on a hard surface.
Although a Morton's neuroma is a nerve entrapment between the 3rd and 4th knuckle, a neuroma can develop between any of the knuckles in the foot.
A neuroma can be treated early by eliminating pressure over the nerve. This can be a wider shoe, open sandal, or an orthotic with a metatarsal or neuroma pad. Cortisone injections can also be effective, but long term results are unpredictable. If this fails then
Traumatic neuromas develop due to direct injury of the nerve. This can create chronic pain right at the area of injury with associated numbness and tingling. Oral medication can help reduce the painful symptoms. Cortisone injections are usually more effective, but the results are often temporary. Sclerosing injections, surgical decompression, or excision is often needed to eliminate symptoms long term.
destruction of the nerve needs to be considered to eliminate pain. Because this is a sensory nerve, destruction is an acceptable treatment. This can be done through a series of sclerosing injections where medical grade alcohol is injected directly around the nerve. Although this sounds painful, most patients tolerate this extremely well. Surgical excision or decompression is also another option with excellent results.