WHAT ARE NEUROMAS?

Commonly called a Morton's neuroma, this problem begins when the outer coating of a nerve in your foot thickens. This thickening is usually caused by irritation that results when two bones repeatedly rub together (often due to ill-fitting shoes or abnormal bone movement). The area between the third and fourth toes is the most commonly affected; the area between the second and third toes is another common irritation point. Nerve problems due to diabetes or alcoholism may also cause neuroma-like symptoms.

Symptoms

The pain from neuromas may start gradually, causing burning, tingling, cramping, or numbness. Symptoms often occur after you've been walking or standing for a period of time. It might feel like you're stepping on a lamp cord. You may need to take your shoe off and rub your foot. In some cases, the pain radiates from the tip of the toes to the ankle.  

Evaluation

To help diagnose your problem and determine the best treatment for your neuroma, your podiatrist looks at your medical history, thoroughly examines your foot, and performs any necessary tests.   

Medical History and Physical Exam

Your podiatrist talks with you about your symptoms, the frequency of your pain, and any past medical history that could involve nerve problems. Then your podiatrist examines your foot carefully, palpating (pressing) the areas around the neuroma to determine the extent of your pain.

Tests

X-rays may be used to help identify a possible neurorna, or to rule out other causes of the pain. Ultrasound, which uses sound waves to show internal soft tissue, may also be performed. Another diagnostic test, which can also relieve pain, involves blocking the nerve by injecting anesthesia around it. Occasionally, magnetic resonance imaging (MRI) may be done to reveal cross-sectional images of soft tissue and bone.