NEUROMA
By: Corinne Gehegan, DPM
 A neuroma is a benign growth of nerve tissue that is often likened to a
pinched nerve. Neuromas most often occur between the 3rd and 4th digits
of the foot, however, a neuroma can develop between other digits as
well. The condition may manifest as pain at the ball of the foot,
burning, tingling, numbness, a sensation that the sock is bunched up
under the toes, or a sensation of stepping on a marble. In the majority
of cases there are no visual physical signs of the condition. Some
individuals may notice that the space between the 2nd and 3rd digits or
3rd and 4th digits is greater than normal. One may be more susceptible
depending on the foot type, the degree and type of activities, footwear,
and trauma to the nerve. Shoes that crowd the toes and high heeled shoes
are often implicated as a cause for neuroma development. Repeated
stresses from certain occupations or athletic activities may be
associated with development of neuromas.
Individuals who suspect that they have a neuroma should seek
professional care to confirm the condition and ensure that the cause of
the symptoms is not related to another type of soft tissue mass. Early
treatment is optimal. Although a neuroma can not be seen on x-ray, one
should be taken for a complete diagnostic picture. Individuals should
have their feet measured to determine the most appropriate shoe size as
the length and width of the feet may change over time.
Treatment may be as simple as changing the shoe size, wearing wider
shoes, or wearing styles that do not crowd the digits and the forefoot.
Soft soled shoes may provide shock absorption. Oral anti-inflammatory
medication, injection therapy, topical analgesics, strategically placed
padding, and orthotics resolve most cases. Injection therapy may involve
cortisone to decrease inflammation or dehydrated alcohol to sclerose the
nerve.
As a last resort surgical management may be entertained. Surgical
management may involve the release of a ligament to decrease the degree
of compression on the nerve caused by the adjacent metatarsal bones.
Surgical excision of the neuroma may be performed as well. Excision of
the neuroma may result in loss of sensation to the toes which the nerve
supplies. A stump neuroma is a painful condition that develops from
inadequate excision of the neuroma or from regeneration of the nerve at
the level where it was cut. Surgical techniques may be employed to
minimize the occurrence of a stump neuroma. Cryosurgery is also
performed to eliminate neuroma symptoms. Surgical options and their
associated risks and benefits can be discussed with the doctor. Surgical
procedures for neuromas are performed in a same day surgery setting with
an average recuperation of three weeks.
Article written by Dr. Corinne Gehegan
To schedule an appointment call (201) 840-7373.
Click here to go back to home page.
|
