First described in 1940, this refers to the abnormal thickening of a nerve in the foot which is aggravated by pressure and movement from bones in the foot known as metatarsals. Further aggravation of the nerve occurs when it is dragged across a ligament deep in the foot known as the deep transverse metatarsal ligament.
This condition is often aggravated by bending, squatting and tight shoes. This may result in burning, cramping and shooting pains in the foot. The individual may also feel other abnormal sensations, such as a marble in the shoe or a bunched-up sock beneath the foot.
It is important to be evaluated by your foot specialist to rule out more serious conditions such as neuropathy which has profound effects on the foot and can lead to very serious limb complications. During a physical exam, your physician can differentiate the various sources of nerve pain.
Depending on the individual the treating doctor or may use a variety of treatments directed at relieving the irritated nerve such as medicine, wider shoes, injections, custom arch supports in which a plaster impression is taken of the foot which balances more effectively the foot’s interaction with the ground and reducing or alleviating the pain completely.
Patients unresponsive to conservative measures may require outpatient surgery. Proper preparation for surgery involves taking x-rays and possibly doing special imaging studies such as ultrasound or MRI to analyze the extent of the neuroma and its location. Surgery is done on an outpatient basis and will require medical clearance from your primary care physician.
During the procedure, which a tiny camera is placed in the foot and small incisions are made to cut the ligament binding the neruoma, thereby releasing the tension and source of inflammation while preserving sensation to the area. Post-operatively the patient will have to wear a special surgical shoe and be given additional instructions from their surgeon. Both of our doctors are trained in this latest endoscopic surgical technique for neuroma.
Because there are many sources of nerve pain, a visit to your podiatrist is recommended for a thorough examination and appropriate imaging studies.