Neuromas are basically irritated nerves, most commonly between the third and fourth toes. Neuromas are caused by tissue rubbing against and irritating the nerves. Pressure from poorly fitting shoes or an abnormal bone structure can also lead to this condition. Symptoms may include sensations of thickness, burning, numbness, tingling, or pain in the ball of the foot. It is not unusual for the patient to say that it feels just like the sock is rolled up under the toes - but it isn't.
When you step on the foot, the toes may even spread apart. Pressing the sides of the foot together will often duplicate the pain.
Treatments generally include everything from conservative care to surgery. Make sure that the shoe is wide enough for the foot is important. (And most of us wear shoes that are really too short and/or too narrow.) Other than that, there isn't much else that can be done at home.
What do we do in the office? We pad the shoes, try physical therapy, consider custom-made orthotics, try a series of steroid injections (or homeopathic injections, if cortisone is not an option). In severe cases, surgery may be necessary.
Surgery is uncommon, since other methods usually work. If surgery is indicated, it is usually done in-office, under local anesthesia. The older approach involves removing part of the nerve - we do not use this technique. We make a small (3/8" inch) incision on top of the foot, and cut the ligament that is irritating the nerve. We have been using this technique for over 15 years, and people have reported at least 85% relief. They also say that they are pleased with the result.
