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Neuroma

Definition: A Neuroma is a benign nerve tumor.

It is fairly common in the feet where there are friction and trauma, or with mechanical imbalance on hard, flat surfaces.  Normally, the major nerves pass deep inside of the ankle bone through the bottom of the foot, extending between the metatarsal bones and out to the sides of the toes.

A Neuroma can occur anywhere there is irritation to the nerve sheath.  Nature actually made an anatomical “mistake,” by putting nerves under the weight bearing bones.  Nature did not plan on hard, flat surfaces or thin soled high heels.  Trauma to the nerve causes a thickening of the nerve sheath producing scar tissue and causing nerve pains.  The most common location is between the third and fourth metatarsals.  This Neuroma was first described by Dr. T.E. Morton (not the same D.J. Morton who described foot imbalance).  It is often called Morton’s Neurom or Morton’s metarsalgia.

Neuromas also can occur between other metatarsal spaces or under the heel when associated with the heel spur syndrome.  Neuromas produce needle-like shooting, electric or tingling pains with certain standing positions.  As they advance, they can produce numbess or muscle cramping in the affected toes.

About 50% of all Neuromas can be relieved with conservative treatment.  First, the person must wear a shoe that does not cramp the feet.  Sometimes, they must change the heel heights in order to change the weight-bearing point on the foot.  Orthotics or pads to separate the metatarsals might help.  If not, professional help is needed.  The Neuroma may respond to local anti-inflammatory injections, orthotics, or it may require surgical removal.  This is a soft tissue procedure (no bone surgery) so disability is minimal and the person is able to bear weight immediately after surgery.