How Do You Treat A Neuroma In A Foot?
A neuroma in the foot is also known as Morton’s neuroma, plantar neuroma, Morton’s neuralgia, intermetatarsal neuroma or Morton’s metatarsalgia. It is a very common occurrence and usually found between the plantar surface of the third and fourth toes. Morton’s neuroma is a non-cancerous or benign growth of nerve sheath due to inflammation and irritation caused over time at the base of the foot leading to various signs and symptoms.1
How Do You Treat A Neuroma In A Foot?
The most common reason for seeking treatment for Morton’s neuroma is the unbearable pain experienced by the patient. So, the primary treatment is aimed at alleviating the pain along with other symptoms of paresthesias and inflammation. Trigger should be identified, be it the shoes or anatomy of the foot or some injury to the foot. Steps should be taken to combat trigger, including avoidance of improper footwear, using orthotics, etc. analgesics and anti-inflammatory medications may help relieve the symptoms of pain and inflammation. Ice compression is also found very helpful in relieving the symptoms of pain and inflammation. On occasions, corticosteroid injection might be needed to settle inflammation of the nerve. Other treatment options include physiotherapy, massage, foot exercises, acupuncture, electrotherapy and unloading taping techniques.
After the alleviation of pain and inflammation, it is important to restore the normal range of motion of the foot as neuroma pain can be really debilitating and hinder complete range of motion of the foot. This can be achieved by massage, joint movement, exercises including joint and muscle stretches, alignment techniques, taping and orthotics. A podiatrist may refer to a physiotherapist who will help achieve normal range of motion of the foot.
To correct aberrant biomechanics of the foot, it is important to achieve normal foot muscle strength and posture. A physiotherapist is best at assessing the correct foot exercises and techniques to regain correct muscle strength and control.
The main treatment goal is to restore the full function of the foot and return to normal daily activities. For the prevention of neuroma recurrence it is advised to avoid the triggers, such as high heels and if foot anatomy is the culprit then, foot orthotics is recommended.
Most of the cases of neuroma are treated with conservative treatment and although, surgery for neuroma is available, very few patients who do not respond to non-surgical approaches are opted for surgery. When symptoms persist after 6-12 months and seem to get worse, surgery is recommended. Surgery is aimed at relieving the symptoms and can be achieved either by removing the nerve or the pressure on nerve by removing the surrounding structures, such as fibrous tissue and ligaments leading to the symptoms. Although, surgery is a safe option, it may lead to permanent paresthesia of the foot. Consulting a podiatrist is the best option.
Causes And Symptoms Of Neuroma Of The Foot
Although, the exact cause of Morton’s neuroma is still unclear, there have been various hypotheses regarding the formation of neuroma of foot.2 Overall, the biomechanical changes in the foot leading to irritation of the local nerves and tissues lead to neuroma of the foot. These may include an abnormal architecture of the foot, such as flat foot or high-arched foot; or improper footwear, such as tight fitting shoes, high heels, shoes with narrow toe boxes; or trauma to the foot damaging the nerve; or continuous stress to the foot can worsen a neuroma.
Generally, women are more susceptible to neuroma due to the culture of wearing high heeled shoes. Patients are invariably inflicted with pain and paresthesias. The pain might be radiating, sharp, shooting and burning in nature that might be aggravated by walking. Numbness and tingling of the toes and ball of the foot might be noted. A noticeable lump or growth is usually rare and on occasions swelling between the toes might be noted. The symptoms worsen with time and on rare occasions patients might even be symptom less.