Oh my aching feet, part 2

Morton’s Neuroma ( intermetatarsal neuroma)
A neuroma is a thickening of a nerve tissue as a result of chronic compression, irritation and or scarring. This creates an enlargement of the nerve leading to the symptoms.
Symptoms may include:
– A burning , numbness or tingling in the ball of the foot extending into the toes. ( typically the 3rd and 4th toes)
– A feeling that something is inside the ball of the foot or like your sock is bunched up in your shoe.
Symptoms may begin gradually and are generally relieved after removing tight shoes, massaging the area or avoiding aggravating factors. Overtime, symptoms may become more persistent.

Treatment:
Initial treatment focuses on eliminating activities that may be contributing to the pain. These include repetitive trauma to the ball of the foot during activities such as running or aerobic classes.
Changing footwear. Changing footwear to a shoe with a wider toe box , arch support and increased cushioning as well as reducing the use of shoes that increase direct pressure on the ball of the foot ( ie. high heels). are an essential first step in treatment.
Padding the ball of the foot to decrease pressure on the metatarsal heads reduces direct trauma to the nerve.Sometimes a custom made orthotic insert may be warrented.
Decreasing local inflammation with the use of ice
Oral medications to reduce inflammation include NSAIDS.
Stretching exercises for the foot and ankle
Myofascial release and massage to reduce adhesions and improve blood flow
Injection therapy – A series of local cortisone injections to the area may be beneficial to reduce local inflammation and decrease nerve irritation

Newer treatment plans may include:

IOVERA / Cryotherapy nerve blocks- After administration of a local anesthetic, a cryotherapy nerve block may be performed to freeze the nerve and give immediate relief from pain lasting several months. This in combination with the above treatment plans can lead to a permanent solution to pain from an inflammed neuroma..

Occasionally, surgical intervention may be required for persistent pain, not responding to conservative treatment.

A proper diagnosis and treatment plan are essential in preventing chronic nerve irritation and pain from a Morton’s neuroma. If you think you may be suffering from this problem, please visit me at my office