Spring is in the air and runners are hitting the streets to get back in shape after a long winter. The combination of wearing narrow, pointed-toed shoes or tight boots at work and the pounding their feet endure from running on hard surfaces can cause a neuroma, a painful nerve disorder of the feet.
Active men and especially women who enjoy running, especially those with flat feet, are prone to develop neuromas. A nerve located between the toes becomes enlarged and inflamed and produces tingling, burning pain. The symptoms begin gradually and if left untreated, progressively worsen.
We see neuromas quite often in younger professional women who wear high heels every day at work or are active runners. Neuromas enlarge as the condition progresses, causing pain and numbness to a consistent area at the base of the toes. Patients often complain it feels as if something is stuck inside the ball of the foot. The symptoms may go away temporarily by massaging the foot, wearing wider shoes with low heels, and avoiding running and other activities that aggravate the condition. Symptoms become more intense as the nerve enlarges and the temporary damage becomes permanent, so it’s best to seek treatment if discomfort persists for more than a few days.
Neuromas can develop in different areas of the foot. The most common occurrence is called Morton’s neuroma, which develops at the base of the third and fourth toes. Thickening and swelling of the nerve usually is caused by compression and irritation from wearing narrow shoes or high heels that crunch the toes in the front of the shoe. In addition, neuromas can result from running, racquet sports and other physical activities that exert repetitive stress on the forefoot such as standing for long periods of time or working on ladders.
A neuroma isn’t detectable by x-ray, so the diagnosis is based on symptoms and a physical examination to palpate the nerve or elicit a notable response during exam.
Treatment options for Morton’s neuroma depend on how far the condition has progressed. At early stages, padding lessens pressure on the nerve, icing reduces swelling, over-the-counter anti-inflammatory medications decrease pain and inflammation, and prescription or custom orthotic devices provide support to reduce compression. Sometimes a steroid injection can be administered to decrease inflammation. Patients also are advised to wear wider shoes with low heels and take a break from running or other activities until the condition improves.
In severe cases, if conservative management options have failed surgery might be the best option to provide relief. Surgery for neuromas is typically a short outpatient procedure that has a very high success rate and short recovery.
For more information on neuromas and other foot and ankle conditions, contact Dr. Hopkins office at 360-456-3171 or visit our Web site www.ssfoot.com.
