Morton's neuroma is a common diagnosis that we see in our practice. A neuroma in the foot presents most commonly with pain in between the third and fourth toes with pain in the ball of the foot. Pain is usually burning, tingling, and shooting pain that radiates into the third and fourth toes and sometimes into the 2nd and 3rd toes. A neuroma usually feels like a sock rolled up in the shoe and feels better upon taking off the shoe and sock. We most commonly see neuromas in women that wear high heel shoes which places much force on the ball of the foot which can irritate the nerve. Neuromas develop over time as well when the fat padding on the ball of the foot reduces as we age.
Dr. Brown and Dr. Saffer practice philosophy has changed over the years regarding the treatment of neuromas. At the most recent American College of Foot and Ankle Surgeons lecturers this year support more conservative treatment for neuromas versus surgical excision as in years past. The one dreaded complication of neuroma surgery is a "stump neuroma" which is a regrowth of the nerve which can cause painful symptoms.
Dr. Brown and Dr. Saffer have had much success with conservative treatment with eventual resolution of neuroma symptoms. Conservative tx options that our practice follows are: NSAIDS, ice, offloading with pads and Orthotics, cortisone injections (max three per year), and the more state of the art treatment alcohol sclerosing agent injections. These type of injections deaden the nerve and reduced symptoms and up to six to seven injections if needed per year can be given. This type of treatment has really helped our patient population that has either suffered through complications of previous surgery or who have not had relief with other conventional treatments. Cryotherapy which is freezing of the nerve is another option as well. Surgical excision is typically the last option for our patients.
Dr. Saffer has suffered from a neuroma several years ago and had relief and resolution with conservative treatment. It is also very important to know if you have pain on the ball of the foot it is not always a neuroma. It could be bursitis, capsulitis, stress fracture, or arthritis. Please refer to our website for more information on neuromas.