NEUROMAS
Neuromas
A neuroma
(also called a Morton's Neuroma, a "pinched nerve" or a nerve tumor) is a benign swelling of a nerve most often between the third and fourth toes; however, it can occur between any of the toes. Usually, one will have a burning, tingling, or numb sensation between the toes and in the ball of the foot, especially while walking. People often describe the pain as having a stone in their shoe, or that their sock is bunched up beneath their toes.
Neuroma Causes
The exact cause is uncertain. However, several factors can contribute to the formation of a neuroma:
- Foot deformities like having either a high arch or flat foot can lead to a neuroma, as these foot types tend to be more unstable.
- Injury to the foot can damage the nerve and cause swelling of the nerve.
- Shoes. Any shoe that squeezes the toes together can cause a problem. Heels taller than two inches tend to put more pressure on the ball of the foot where the nerve is located and can cause the nerve to become inflamed.
- Repetitive stress to the foot, common in many occupations, can aggravate the nerve.
Neuroma Diagnosis & Treatment
The diagnosis of a neuroma is typically based on the patient's symptoms and examination of the foot. Often, Dr. Sheff will perform an ultrasound exam as well, which can visualize the inflamed nerve and help provide a prognosis based on the size of the inflamed nerve. Treatment varies depending on how severe the pain is.
Shoe selection
Any shoe that pinches your toes together should be avoided, and any shoe with a heel higher than two inches can be a problem, as each of these can cause irritation to the nerve.
Orthotics
Often a simple pad [called a metatarsal pad] can be worn in the shoe to help take the pressure off the nerve and relieve the pain. Although this is often extremely effective, it will not cure the condition, but correct it, and it is important to wear the orthotics as often as possible.
Medications
Anti-inflammatory drugs and cortisone injections can be used to ease acute pain, but these are only temporary, and once their effects have worn off, the pain will quickly return. However, neuromas can be successfully treated with a series of dehydrated alcohol injections, which basically "shrink" the nerve.
These injections are performed in the office under ultrasound guidance and given between two and three weeks apart. The benefit of injection therapy is the word cure
can be used, as opposed to simply treating the symptoms.
Laser Therapy
The laser utilized in our office serves to increase the body's ability to heal. By exposing the inflamed nerve to a series of laser treatments, the body can bring down the inflammation of the nerve. The advantage of the use of the laser is the fact that it is 100% painless with absolutely no side effects. Often patients require 6-8 sessions of laser therapy with each session lasting seven minutes.
Surgery
When all else fails, surgical removal of the inflamed nerve will effectively cure the condition. However, one rarely needs surgery, given the success rates with injection therapy. Surgery is performed as an outpatient basis at Newport Hospital.
Call Newport Family Foot Care
at 401-846-8050
to schedule an appointment.
You can't have everything. Where would you put it?
- Steven Wright
