A neuroma is a thickening of the nerve tissue that often appears as a ‘lump’. They are benign occurrences and if it occurs on the underside of the foot often feeling like a hard ball causing pain it is a condition known as Morton’s neuroma. They are most usually found in the space of tissue between the third and fourth toes.
What Causes the Neuroma?It is believed that the neuroma begins as an enlarged nerve, possible caused by frequently wearing high heeled or tight shoes, or from having flat feet. As the nerve enlarges, it can entwine and combine itself with other nerves and vessels in the surrounding area due to the small amount of available space in the foot, resulting in a thickened growth of tissue.
Signs and SymptomsOften the person will have no particular symptoms initially, but as the growth develops, pain can be caused as the expanding tissue growth applies pressure to the surrounding tissues and nerves. This pain can be exacerbated by wearing tight fitting shoes or being unable to allow the feet to spread and relax without being in the confines of a shoe.The pain sometimes begins as a burning sensation in the foot that can radiate to the toes progressing to feelings of numbness or tingling.
Treatment for Morton’s NeuromaMost people seek advice from their GP as the pain develops and persists, who will then examine the foot for signs of tissue or bone damage and lumps. A range of physical tests such as degree of flexibility, motion and resistance will help to determine the origin of the problem and will allow the physician to rule out any other possible causes of the pain, such as arthritic problems that are far more common.X-rays and scans can be used to confirm the diagnosis and to ensure the growth is benign and not a potentially more serious tumour.
As these types of growths are not malignant, they are best treated conservatively without the need for invasive procedures, though this is not successful for everyone. Padding and amending the footwear are often all that is needed to help alleviate pain and to allow the tissues to reduce in size and return to their normal anatomical state.Arch supports and strategically placed strapping can help support a flat foot and to help weight disperse differently in the foot whilst healing takes place.
Oral painkillers and anti-inflammatory medications can be used to help reduce initial pain but their long-term use is not recommended.As pain is often greatly reduced at rest, when wearing no shoes or wide fitting breathable shoes, it is recommended that these are worn when possible and heeled shoes are kept to a minimum.
Occasionally for persistent or severe pain will require the use of a local anaesthetic injection or a steroidal preparation. This will be performed by either your GP or by a foot health specialist such as an orthopaedic physician or podiatrist.
Many people will need surgery to relieve their symptoms and this can be performed again by an orthopaedic surgeon or a podiatrist. An incision is made on either the upper or lower side of the foot, and using very delicate instruments, the pressure on the growth, often caused by a swollen or toughened ligament, is relieved by trimming or cutting it.
Morton’s neuromas, although not seriously detrimental to health, can cause a great deal of pain and suffering for the affected person and can alter their quality of life and mobility. It will need treating whether this is conservatively or surgically.