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Family Foot & Ankle

Neuroma: Thickened Nerves That Tingle

Can you remember the last time a small pebble got stuck in your sandal or your shoe? How about a bunch in your sock right under your toes? The natural response is to clear the foreign object or smooth out the offending build-up as quickly as possible. If you start to feel that way all the time—even when nothing is there—you may have developed a Morton’s neuroma. In this potentially painful condition, a benign growth of nerve tissue amasses in the ball of your foot, classically between your third and fourth toes, and can be quite a nuisance.

Symptoms and Causes of Nerve Pain

In addition to pain from pressure on the growth as you stand and walk, neuromas can also be responsible for tingling or burning sensations, numbness, and swelling. The pain is usually worse when you walk, and may improve with rest.

The precise cause of the growth is not entirely clear, but a number of factors seem to contribute to its formation. A foot deformity that causes instability in toe joints, such as high arches or flat feet, may be a contributing factor. Tingling and painful nerves are also more common among those who frequently wear tight shoes or high heels, as well as those who have suffered recent or recurring trauma to the forefoot.

Home Care

In many cases, you can reduce the pain and discomfort from this condition with a few simple at-home adjustments or remedies. Check with us if over-the-counter anti-inflammatories such as ibuprofen or naproxen are safe for you. They can help manage pain and swelling, as can ice or massage.

A longer-term solution is to improve the quality of your footwear. Neuromas need shoes with plenty of room (width and height) at the front to allow toes to move. Low heels also prevent your weight from shifting forward—if you must wear high heels for a special occasion, 2” should be the absolute maximum. Lastly, you want insoles that are thick and cushioned to absorb shocks; over-the-counter inserts may help with this.

Conservative Treatment

In some cases, a switch in footwear may be the only “treatment” you need. However, we also offer a wide variety of other conservative, non-invasive options designed to reduce pressure and friction on the neuroma and prevent it from getting worse.

If over-the-counter insoles are not effective, we often recommend custom-made arch supports, foot pads, or even full orthotic devices to help you relieve pressure. These are a little more expensive than their OTC brethren, but they last a lot longer, and they’re designed to fit the precise contours of your feet.

For acute pain and inflammation, we may prescribe tougher pain medications or cortisone injections.

Surgical Treatment

We always exhaust conservative options first, but if a neuroma is still causing pain and limiting your mobility, we may consider a surgical procedure, commonly an excision of the nerve growth. Although the surgery is highly successful on average, it comes with the standard risks of any operation, including infection or permanent numbness in the affected area. If we think surgery is right for you, we’ll walk you through the pros, cons, and risks of any procedure.

If you start to feel like you’re permanently standing on a pebble, don’t wait—call Family Foot and Ankle Center today to schedule an appointment. The earlier the problem is detected and addressed, the more likely that simple solutions will be effective and long-lasting. You can schedule an appointment at one of our 5 Greater Cincinnati locations online, or give us a call at (513) 728-4800 or (859) 282-1572.