A benign nerve tumor that can occur anywhere there is an irritation to the nerve sheath or covering around the nerve. When there is a biomechanical imbalance, trauma or friction to the foot, there is the potential for a neuroma to develop. When two metatarsal bones are squeezed together, they may pinch the nerve that runs between them. Pressure from the bones on the nerve can cause a thickening of the nerve sheath. The pinched nerve can become swollen and painful.
Neuromas are most commonly found between the 3rd and 4th metatarsals but can also occur in other metatarsal spaces or under the heel. The pain from a neuroma may often start gradually and is described by patients as a tingling, needle-like shooting pain associated with cramping or numbness. The pain may radiate to other parts of the foot and up the ankle.
A proper diagnosis is essential as nerve problems may be due to diabetes or other conditions that may also cause neuroma-like symptoms. A significant number of neuromas can be treated conservatively with orthopedic modifications, injections, physical therapy, medication and changes in footgear. In about 30% of the cases, surgical intervention is necessary and has a high degree of success. This is an outpatient procedure for an excision of neuroma under local anesthesia. Because of the etiology (cause) of a neuroma, there is a 5% recurrence rate even with the most careful surgical procedure. Therefore it is important to follow up with your podiatric physician who can recommend ways to lessen the likelihood of recurrence.