A neuroma is a painful condition that affects the ball of your foot, most often between the third and fourth toes. The tissue surrounding a nerve leading to the toe becomes thickened and swollen and can often feel like you are “standing on a marble.” Neuromas are much more common in women than men, and typically develop from irritation, excessive stress, or a trauma to the foot. Burning pain, toe numbness and tingling, and a feeling of fullness under the forefoot can occur.
Tight, narrow shoes, high impact activities, and walking barefoot can exacerbate symptoms. The physician will examine your foot and often be able to feel a small mass or click under your foot. Often times, x-rays are ordered to rule out any stress fracture or arthritis.
Initial treatment includes anti-inflammatory medication and proper-fitting shoe wear to reduce pressure on structures in the forefoot. Shoe inserts and cushion pads may also reduce compression of the nerve and relieve symptoms. Corticosteroid injections have a strong anti-inflammatory effect and can reduce the swelling and irritation around the nerve. The majority of individuals will have symptom relief with a combination of nonsurgical treatments.
If conservative treatment fails to relieve symptoms, your surgeon may discuss surgical treatment. The procedure is an outpatient surgery performed under a type of anesthesia. The surgeon will make a small incision and remove the neuroma and surrounding tissue. It may take 3-4 weeks before you will feel comfortable walking after surgery.