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A Neuroma is a painful condition, and is commonly referred to as a pinched nerve. It is an abnormal growth of nerve tissue traditionally found between the 3rd and 4th toes. The condition can cause changes in sensation to the digits, tingling, numbness between the toes and in the ball of the foot.

The primary symptom associated with a neuroma is pain between the 3rd and 4th toes on the ball of the foot. Patients suffering from this condition often find relief by stopping their walking, taking off their shoes and massaging the area. Sometimes patients will describe the pain as similar to having a marble or rock in the ball of the foot. Women suffer from neuromas more commonly than men.

Although the exact cause is unclear, a number of factors are suspected in the development of a neuroma. Biomechanical deformities, such as high arched or flat feet can cause a neuroma. Certain foot types cause instability around the toe joints, which can lead to the development of a neuroma. These biomechanical forces can cause repetitive trauma to the nerve resulting in inflammation of the nerve itself. Improper footwear that causes the toes to be squeezed together and heeled shoeshigher than two inches increase the pressure on the forefoot and to the nerve locally. Certain types of occupations that require prolonged standing or walking can also create or aggravate the neuroma. Initially, patients who feel they may have a neuroma can attempt to accommodate their shoe gear. Proper fitting shoes with plenty of room for the toes and low heels can improve symptoms. Shoes with thick, shock absorbing soles may also help. High heels should be avoided whenever possible because they increase forefoot pressures.

Treatment options vary greatly with the severity of each neuroma and evaluation by a physician is recommended. If addressed early, most patients will not require surgical intervention. The primary goal of early treatment is to relieve pressure and to prevent more severe symptoms from developing. X-ray evaluation is typical in the evaluation of a neuroma. Mainstay treatments included padding and taping, antiinflammatory medications, cortisone injections and orthotic devices. Surgical options are typically
not considered until conservative treatments have failed to relieve the patient’s symptoms. Surgical intervention usually requires removal of the affected nerve.

Remember that feet are not supposed to hurt and that any foot pain is not normal. Disruption in foot
function can decrease productivity and mobility. If you or a patient are experiencing foot pain, please contact our office and schedule an appointment with one of our physicians.

About the Author
Dr. Bryant is a native Kentuckian, and a graduate of Hanover College and the College of Podiatric Medicine in Cleveland. He completed three years of Post-Graduate Training in podiatric medicine and surgery. Dr. Bryant specializes in the conservation and surgical treatment of bunions, hammertoes, neuromas, warts, ingrown toenails and heel pain. Dr. Bryant also has experience in modern techniques and procedures.

In Dr. Bryant’s spare time, he loves to spend time with his family and friends. He is part of the Lexington Singers and performs with the University of Kentucky’s “Grand Nights” every summer. He loves to travel to new places and take long walks with his dog Allie.

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