Neuromas – Vanquishing Phantom Forefoot Pain

by | Apr 26, 2018 | Nerve Pain

The Phantom Pebble

You’re walking along, and it feels like you have pebble in your shoe, right up near the front of your foot.

Hopefully, there’s an actual pebble in there. It’s the ideal situation, and has the simplest home remedy to boot!

But what if you don’t find any foreign object in there, and that sensation just stays? Not only that, it might become painful when you place weight on your foot. You might even feel a tingling or numbness in the area sometimes, or see swelling in your forefoot or between your toes.

There’s a good chance you have a neuroma, and unfortunately, it’s not something you can shake out of your shoe.

Examination of the Foot

What Is a Neuroma?

Your nerves are very sensitive instruments, especially in places like the feet and hands where touch is essential. You want to know if that stove or pavement is hot as soon as possible, don’t you?

That sensitivity isn’t always a blessing, however.

A neuroma is a thickening of the tissue around a nerve, which can make a sensitive area even more sensitive. Imagine squeeze your hand around something delicate. That pressure has an effect!

The thickening tissue of a neuroma is thought to be caused by excessive pressure, irritation, or injury in the area.

When it comes to the ball of your foot, it might be the repetitive stress of jogging or running that can trigger such a response. If your treks along North Bank are getting ruined by pain, a neuroma might be a culprit.

Another cause might be high heels or improper footwear placing too much pressure against the front of the foot. In still other cases, there is an abnormality in the shape of the foot that is putting more pressure than usual on the nerves of the toes (think high arches, flat feet, bunions, and the like).

You might also hear the name “Morton” used in conjunction with neuromas. This is just a more specific term for a neuroma in the ball of the foot. Most frequently, “Morton’s neuroma” is used to refer to a growth between the third and fourth toes.

What to Do About a Neuroma

The first big question is always: So when should I come in to see you?

Not every pain in the ball of your foot is going to be something in need of treatment. You might just have a bruise or other small pain that improves with a little time.

That said, don’t try to put off addressing pain that lingers for a few days. There’s really no benefit in doing so, and it’s especially concerning if attempts to rest or shift your activities away from aggravating your foot haven’t helped.

Determining the source of your pain—whether a neuroma as opposed to a stress fracture, for example—will be an important element of recommending the most effective treatment plan.

A neuroma can often be felt for by gently pressing on the area and feeling for tenderness. In some cases, an imaging test might be recommended to ensure what we’re dealing with and its exact location.

Doctor Consultation

Conservative Treatments

We always wish to start out with conservative treatments whenever possible. Depending on your lifestyle and the natural factors that might be at play in your neuroma troubles, we may recommend one or more of the following:

  • Changing Footwear – The bad news is that your favorite shoes might be causing your neuroma pain. The good news is that there are worse fates, and this one is relatively easy to remedy!

High heel use will have to go down. You will also want roomier toeboxes in the front of your shoes. Buckles or laces that provide more customization of width are ideal.

  • Adding Cushioning and Correction – Sometimes shoes (and the feet inside them) need a bit of help. Arch supports and cushioned inserts can be bought over the counter. However, in some cases we might recommend custom-made items for better effectiveness.
  • Rest, Ice, Massage – Classic techniques are classic for a reason. In addition to lessening the activities that might be responsible for your neuroma pain, at home can also be effective.

Ice and massage can be knocked off at the same time, and feels great. Freeze water in a paper or Styrofoam cup, then roll your foot along it. Make sure to use a cloth and not directly expose your foot to ice!

Advanced Treatments

It is always our goal to handle a problem with conservative treatments whenever possible. Sometimes, however, those treatments are not enough to handle the issue. The problem might also be in a state where it only makes sense to move to advanced treatments now.

Surgery might be necessary in some cases to provide lasting relief of a neuroma. This might involve a “release” or decompression of the nerve by cutting the tissues surrounding it. Our office specializes in minimally invasive techniques of nerve decompression with little to no scarring.

We will be sure to completely discuss all the options for neuroma treatment available to you, including benefits and risks involved, so you can make an informed decision about your care.

The sooner a condition like a neuroma is diagnosed and addressed, the better the odds that conservative care will bring the relief you need. Schedule an appointment with our Roseburg office by calling (541) 673-0742 or filling out our online contact form.

The pain and discomfort of a neuroma might make you think you’re going batty, but Wilks Advanced Foot Care can help you kick that phantom pebble to the curb!