Could it be a Neuroma?

Does foot pain and numbness – usually in the ball or heel of the foot make it difficult for you to get through the day? You may even experience a burning, tingling or numbness in toes. Toes may cramp and curl or twitch. Pain can quickly accelerate and become sharp, almost excruciating with an increase in duration. Some people feel as if they are stepping on a pebble, or as if there is a fold in their sock while standing or walking. Pain and discomfort may increase with toe extension or compressing the area (wearing shoes). For some – toe flexion, massaging the area or staying off your feet may decrease pain.

Symptoms necessitate an evaluation to determine the cause(s) of your pain, in order to create a customized treatment program. It may be determined that you have a Neuroma – a swelling, scarring or thickening of a nerve.  “Neur” or neuro” means nerve, and “oma” means swelling or tumor. It can develop between any of the long bones (metatarsals) in the forefoot. It is benign (non-cancerous) and responds well to treatment.

The most common type of Neuroma is called, “Morton’s Neuroma” – also known as Intermetatarsal Neuroma, Plantar Neuroma or Interdigital Perineurial Fibrosis. This commonly affects the nerve between the third and forth metatarsals (toe bones).

Morton’s Neuroma is more common in women than men – perhaps due to footwear. If the space between the metatarsals decrease, ligaments become tight, which can irritate the nerve – causing it to thicken and scar. Some people experience a popping or clicking sensation (Mulder’s sign) when walking. A small mass of tissue around the affected nerve may be felt. If left untreated, nerve damage can result and spread to the ankle and leg. Additionally, balance is affected – which can lead to falling. For these reasons, Morton’s Neuroma treatment is vital.

There are numerous factors contributing to a Neuroma. These include:

  • Biomechanical deformities/forefoot problems: Flat feet, bunions, hammertoe, high foot arch or abnormal toe positioning can affect toe alignment.
  • Spinal Misalignment
  • Footwear: Shoes that are too tight, too high (creates pressure and/or stress), too loose (created friction) or with narrow shoe boxes.
  • Overuse: Often seen with athletes (court sports, runners, hikers, skiers), ballet dancers or occupations that require extended periods of time standing or walking.
  • Health conditions (diabetes, arthritis, gout, overweight)
  • Previous nerve injury (damage during surgery or wound)

Neuroma Foot Treatment Options:

Once the patient completes a thorough health history, an in-depth consultation, a “hands-on” physical examination, biomechanical and gait analysis are conducted. Other tests or imaging studies may be ordered. Then, a diagnosis is made and treatment begins. Treatment options for a Neuroma, or specifically Morton’s Neuroma treatment may include:

  • Podiatry: Custom orthotic devices or inserts, metatarsal pads, foot mobilization, laser therapy, special footwear, oral anti-inflammatory medication, ice therapy, and/or injections of cortisone, local anesthetics or other agents.
  • Physical Therapy: Manual Therapeutic Technique (soft tissue massage, deep friction massage, manual stretching and joint mobilization), Therapeutic Exercises (stretching and strengthening exercises), Neuromuscular Reeducation (padding or taping may be included) and Modalities (ultrasound, electric stimulation, ice therapy) are offered.
  • Acupuncture: Helps to decrease inflammation, increase circulation to the foot, break up scar tissue and reduce/eliminate pain and recovery time.
  • Nutritional Counseling: Let our Medical Doctors and Nutritionist help you lose those extra pounds. Nutritional support may be recommended.
  • Lifestyle Modifications: Epsom salt soaks, massage, activity modification and maintenance care will be discussed with the patient.

Early Neuroma foot treatment provides better treatment outcomes. According to recent studies, 80% of patients who combine conservative therapies respond well and avoid surgery. If you are experiencing pain and/or numbness in the heel or bottom of your foot, or numbness in toes, please seek care by a compassionate expert. In pain… put your feet in our hands!



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