I was just interviewed about neuromas and thought I would write about them.
Each toe has four nerves that supply sensation - two on top and two on the bottom. The bottom nerves of adjacent toes are actually formed by a larger nerve that splits into two at the ball of the foot. Sometimes, the point at which the split occurs gets irritated and inflamed. As a result, the nerve tissue enlargs becomes a nerve tumor. That is a neuroma.
Anything that irritates the nerve can cause a neuroma. Pressure at the ball of the foot from high heel shoes and having high arches are two of the most common causes. Arthritis and bone spurring around the joints that make up the ball of the foot can also cause irritation.
The symptoms of a neuroma can vary greatly depending on the stage of the neuroma development. Early symptoms may simply feel like you are walking on a stone or a lump in the area. More typical symptoms are numbness, tingling or even pain to the two adjoining toes. It is common to have these symptoms at rest or while in bed.
Anything that causes pressure to the area will worsen the symptoms. High heeled shoes put direct pressure on them and narrow shows pinch the neuroma also producing symptoms.
Foot pain is NEVER normal. All too often, people ignore their pain with the hopes of it going away. When pain increases in intensity or is present more frequently or changes in its nature - you are overdue to see your podiatrist! An examination is usually enough to test for a neuroma, but your podiatric physician may also recommend a diagnostic ultrasound or MRI to confirm the diagnosis.
Relieving the pressure on the nerve tumor is the key for conservative treatment. Changing shoes, wearing less narrow and lower heeled shoes can make a big difference. Often, a podiatric physician will use pads and more permanent custom shoe orthotics to control the pressure on the ball of the foot and control any abnormal motion of the foot.
Neuromas can certainly become a chronic problem. Like any inflammed tissue, if the nerve tissue continutes to be inflammed continue to enlarge and will change to include scar tissue and adhesions. Like most foot problems, it is very important to treat this early in its course. Often the nerve tumor can grow to the point that every step becomes painful.