Neuromas

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Serving the Butler area with exceptional podiatric care since 1994

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Serving the Butler area with exceptional podiatric care since 1994

A neuroma is a thickening of the tissue surrounding a nerve, most commonly the nerve that runs between the third and fourth toes. The condition is often called a Morton's neuroma after the physician who first described it, and it is one of the most frequent causes of pain in the ball of the foot among adults. Although the condition is not a true tumor, it can produce surprisingly severe pain that affects walking, working, and quality of life. At Family Foot Care in Butler, PA, our podiatrists are highly experienced in diagnosing and treating neuromas with both conservative and advanced approaches.

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Neuromas develop when the nerve becomes irritated and compressed between the bones of the front of the foot. Several factors contribute. Tight, narrow, or high-heeled shoes squeeze the metatarsal bones together and pinch the nerve. Foot deformities such as bunions, hammertoes, and flat feet alter the mechanics of the forefoot and place additional stress on the nerve. High-impact activities such as running and aerobics, repetitive trauma, and certain occupations involving prolonged standing also play a role. Over time, the body responds by laying down scar tissue around the nerve, creating the characteristic thickening.

The classic symptoms include burning pain in the ball of the foot, often radiating into the toes; numbness or tingling between the affected toes; the sensation of walking on a marble or having something bunched up in the shoe; and sharp, electric-like pains that may strike unexpectedly. Symptoms typically worsen with activity, especially in tight shoes, and often improve when the patient removes their shoes and massages the foot. Many patients describe taking off their shoes mid-day for relief.

Diagnosis is usually made through a thorough history and physical examination, including specific clinical tests in which gentle pressure between the metatarsal heads reproduces the patient's symptoms. We may use diagnostic ultrasound or MRI to confirm the size and location of the neuroma when needed. We also evaluate for other causes of forefoot pain such as stress fractures or arthritis to ensure the right diagnosis.

Conservative treatment is effective for many patients. Wider, lower-heeled shoes with cushioned soles relieve pressure on the nerve. Custom orthotics with metatarsal pads spread the bones apart and support the forefoot. Anti-inflammatory medications, ice, and activity modification all play a role. Cortisone injections can provide significant relief and are sometimes used in a series. Alcohol injections offer another option that can shrink the neuroma over multiple treatments.

For patients whose symptoms persist despite conservative care, surgical removal of the neuroma offers a definitive solution with high success rates. Modern techniques allow precise removal through a small incision, with most patients returning to comfortable activity within a few weeks. Our surgeons carefully discuss the risks and benefits of each approach to help patients make the right decision for their situation.