Neuroma
A neuroma is nerve swelling caused by
external pressure on the nerve. Some clinicians refer to this as a
tumor of the nerve but this is incorrect. There is no tumor of the
nerve at all, simply swelling of the nerve as a result of pressure
from a ligament. Symptoms include burning, tingling or numbness in
the region of the toes. Quite commonly the third and fourth toe are
involved although a neuroma may also occur between the second and
third toe.
The treatment of a neuroma that occurs between the metatarsals (called
a web space or interdigital neuroma) is to decrease the inflammation
and pressure on the nerve. This is done by widening the shoe, avoiding
a high heel, wearing a pad or orthotic support in the shoe, and occasionally,
the use of cortisone injections into the affected area. These treatments
are often effective. If these conservative treatments fail to alleviate
or eradicate the symptoms, then surgery with removal of the nerve
is an option. By removing the nerve, the pain in the front of the
foot and in between the toes invariably decreases, although there
is numbness in between the toes which is present and which is permanent.
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