GALLUZZO FOOT & ANKLE CLINIC

Neuromas

Commonly called a
Morton's Neuroma, this problem is fairly common benign nerve growth and begins when the outer coating of a nerve in your foot thickens. This thickening is caused by irritation of branches of the medial and lateral plantar nerves that results when two bones repeatedly rub together. The area between the third and fourth toes is most commonly affected, followed by the area between the second and third toes. Nerve problems resulting from complications of diabetes or alcoholism may also cause neuroma-like symptoms.

Morton's neuroma shown
on foot schematic

Neuroma with branching
(surgical dissection)
SYMPTOMS
Neuroma pain may start gradually, and causes sharp, burning, tingling, cramping, or numbness, or a combination of these symptoms. A sharp pain may occur at the base of the toes. Symptoms often occur after you have been walking or standing for a period of time. A diagnosis of a neuroma is based on the symptoms described by the patient which may be present with similar symptoms. Stress fractures, metatarsalgia, rheumatoid arthritis, diabetic neuropathy and referred pain from the back are a few conditions that can mimic pain associated with a neuroma. Wearing tight shoes pushes the metatarsals together squeezing the tumor between them and increasing the size of the nerve. You may need to take your shoe off and rub your foot. In some cases, the pain radiates from the tip of the toes to the ankle.

TREATMENT
After your evaluation, your physician will discuss the most appropriate care for your neuroma. Treatment begins with conservative padding and strapping of the foot. Some specific treatments include:

Conservative treatment:
Functional Orthotic Devices- Custom shoe inserts reposition your body weight across the metatarsal area, thereby decreasing abnormal pressure on the neuroma, helping to prevent nerve irritation.

Physical therapy
*Ultrasound Therapy and Hydrotherapy-Whirlpool theurapeutic treatments coupled with sound waves (ultrasound) may help reduce swelling around the nouroma.

*Medication - Cortisone injections or other medication can relieve pain and swelling in the nerve's outer costing.

* Shoe Modifications - Pads can cushion and support the parts of your foot that are vulnerable. Roomy, supportive shoes can help prevent irritation. A change to a more wider shoe can also decrease the pressure on the offending nerve.

*Padding and strapping- Adhesive tape with a combination of adhesive strapping may also be used in conjunction with the above conservative treatment to decrease pressure on the affected nerve

Surgery:
The decision to surgically intervene is based on your symptoms and the judgement of the doctor. If nonsurgical care does not give sufficient relief, surgery may be necessary to remove or decompress the neuroma. A local anesthetic may be used for this procedure, which can be performed in a physician's office, surgical center or hospital. Following surgery, you may feel numbness in the area where the nerve was removed. Your physician will tell you how soon you can be on your feet, but generally you may return to normal activities within three to six weeks.

You can contact Dr. A.J. Galluzzo in Rockford, IL at Tel: (815) 633-3050
or in Chicago, IL at
Tel: (312) 944-2929



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