A neuroma (also known as Morton’s Neuroma) occurs when there is irritation (also called Perineural Fibrosis) around one of the nerves that is going to the toes. The tissue that surrounds the nerve thickens up with fibrous tissue, almost forming a ball, and this can cause splaying of the toes (the toes can form a V).
Presentation is simple...patients often come into the office stating that it feels like they are "walking on a pebble" or like their "socks are bunched up under their toes". Symptoms include but are not limited to numbness, burning, or sharp pains that shoot to the toes.
This condition is aggravated by pointed and high heeled shoegear. However, in the worst cases, the neuroma can become painful with all activities or shoes, and especially with prolonged weightbearing.
Typically, a neuroma can be diagnosed with a clinical examination by a podiatrist. A neuroma is not visible on X-Rays because it is a soft tissue problem, which is generally not visible on plain film. Diagnostic Ultrasound and MRI can be used to identify the neuroma and also to differentiate from other possible similar diagnoses, such as stress fractures, capuslitis, metatarsalgia, avascular necrosis, and plantar plate tears.
The treatment options for neuromas include the following: padding, orthotics, antiinflammatory medication, injections, and surgery. Conservative therapies are always attempted prior to any surgical intervention.
If you feel that you have this condition or another foot problem, please contact Dr. Bender’s Advanced Physical Medicine office at 708-763-0580 (Oak Park) or 773-776-3166 (63rd St.) Dr. Bender is an instructor at William Scholl College of Podiatric Medicine and has been in practice for the last 11 years.