Kelly L. Geoghan, DPM
Board-Certified Podiatrist & Heel Pain Specialist located in Baltimore, MD
If you are suffering from pain or numbness in the ball of your foot, you may have a neuroma - a condition that occurs when the nerves in your forefoot become inflamed. If left untreated, neuromas can make regular daily activities difficult to perform and may lead to excruciating pain with every step you take. Dr. Kelly Geoghan has extensive experience and expertise in treating neuromas successfully. At her practice in Baltimore, Maryland, Dr. Geoghan provides compassionate, skillful care with the most advanced technology and techniques available today to help you find lasting relief and improve the quality of your life.
Neuromas Q & A
What is a Neuroma?
A neuroma is a condition that occurs when the nerves in your forefoot are compressed or irritated and become inflamed. This causes the nerve to swell and the tissues surrounding the nerve to thicken, resulting in a painful mass of scared nerve tissue. The most common neuroma of the foot is Morton’s neuroma, which occurs between your third and fourth metatarsals (the bones leading to the toes).
Most patients describe it as if they are “walking on a stone or pebble,” with pain that radiates from the ball of the foot to the toes. The level of pain can range from dull and mild to severe and sharp. Additional symptoms may include:
- Pain between your toes when walking or standing
- Pain on the ball of your foot
- Numbness or a “pins and needles” tingling sensation in the foot and/or toes
- An uncomfortable separation of your toes
What Causes a Neuroma?
Anything that causes compression or irritation of the nerves in the foot can contribute to the formation of a neuroma. They can occur suddenly, from a trauma or injury, or develop over time through repetitive irritation and stress. Leading factors include:
- Improper footwear, especially high-heel shoes with a tapered toe area that causes the toes to be squeezed together.
- Trauma that damages the nerve, such as an impact from a fall or a heavy object dropped on the foot.
- Genetic deformities that bring instability around the toe joints, such as high-arches, flat feet, bunions, and hammertoes.
- Activities that involve repetitive stress and irritation to the balls of the feet, like running or tennis.
- Occupations that involve prolonged standing, like store clerks, construction workers, and nurses
- Excessive weight gain.
Neuromas are very common, with approximately one in three people affected. Women are approximately 8 to 10 times more likely than men to develop a neuroma. This is mostly due to women’s shoe styles, with high heels and pointed toes creating pressure on the nerves in the feet.
How are Neuromas Treated?
Fortunately, most neuromas can be treated effectively with the right care. Treatment options range widely, from at-home massage therapy to surgery. To avoid an invasive procedure like surgery, early intervention is imperative. That is why we highly recommend you consult with a qualified, reputable podiatrist as quickly as possible.
To properly diagnose and treat your condition, Dr. Geoghan will listen to your concerns, examine your foot, pinpoint your pain, assess the severity of the neuroma, and order X-ray or MRI if needed. She will also review your medical history, current general health, and lifestyle needs. Then, Dr. Geoghan will work with you to design a personalized treatment plan that will relieve your pain and help you perform your daily activities in comfort.
For mild, undeveloped neuromas, simple at-home remedies and lifestyle adjustments may often relieve symptoms and allow the condition to diminish on its own. Options include:
- Wear proper shoes, with arch support, plenty of room for the toes to move, low heels, and shock-absorbent soles, to keep excessive pressure off the foot
- Avoid shoes with heels over two inches tall to eliminate undue strain on the forefoot
- Foot massages and/or physical therapy
- Ice packs, to help to dull the pain
- Over-the-counter shoe pads to relieve pressure around the affected area
- Refrain from high-impact sports, like running and tennis, and standing for long periods of time
- Over the counter anti-inflammatory medications, such as ibuprofen
- Lose any excess weight, to reduce pressure on the feet
For more advanced, severe cases, additional procedures may be necessary. Options include:
- Custom orthotics, designed specifically for your feet, to provide better support than an over-the-counter shoe pad.
- Cortisone injections, to numb the affected nerve, reduce inflammation and pain, and possibly even shrink the neuroma.
- Sclerosing alcohol injections, to weaken the affected nerve and hinder or eliminate its ability to report pain.
- MLS laser Therapy, which uses intense light energy to reduce inflammation, swelling, pain, and recovery time.
- Surgery, called a neurectomy, to remove the affected nerve.
Surgery is usually considered as a last resort because it typically results in the permanent numbness of one or more toes. Neurectomy surgery is performed on an outpatient basis and recovery is generally quick; most patients resume walking in shoes in two-to-six weeks.
Can Neuromas be Prevented?
There are steps you can take to help avoid developing a painful neuroma, including:
- Wear shoes that have enough room around the toes so that they are not compressed,
- Wear shoes with adequate padding in the ball of the foot
- Wear shoes with heels under two inches high
- Maintain a healthy weight to avoid extra pressure on the feet
- Adjust your athletic activities to reduce impact and pressure on the feet
There is no reason to suffer from the discomfort or pain from a neuroma or any other ailment of the foot and ankle. Dr. Kelly Geoghan is a renowned board-certified podiatrist with the experience and expertise to treat your condition, relieve your pain, and help you resume your daily activities in comfort.
Take the first step towards a happier, healthier, more comfortable life! Contact us today to schedule your appointment. We look forward to meeting you!
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