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Foot health

05 September 2011

Neuromas

Neuromas are enlarged, benign growths of nerves, most commonly between the third and fourth toes. They are caused by bones and other tissue rubbing against the nerves.

What are neuromas?

The exact cause of neuromas is unclear. However, it is thought that the head of the bones creating the toe joints on either side of the nerve pinch the nerve, causing inflammation and thickening. Known contributing factors are tight shoes, especially slip-on shoes, high-heeled shoes and biomechanical dysfunction such as flat feet. Also, injury or foot sprains may cause a neuroma.

  • Clinical examination by a physician (usually feels for a palpable click between the metatarsal heads)
  • Diagnostic local anesthetic injection—mandatory prior to surgery
  • X-ray of the foot to rule out other foot pathologies

  • Usually, conservative therapy is attempted prior to surgical intervention. Conservative options for treating neuromas include the following:
  • Lace-up shoes that fit properly and have a wide toebox
  • Padding
  • Orthotics or over-the-counter arch supports
  • Injections of local anesthetic and/or corticosteroids
  • Physical therapy

  • Growth of the neuroma
  • Increased discomfort in the area
  • Inability to wear certain shoes
  • Inability to perform some job duties
  • Need for surgical removal

  •  Occurs in all adult age groups
  •  More common in females
  •  Usually affects only one foot, but may affect both
  •  Usually affects the nerve behind the 3rd and 4th toes

 

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