When a nerve is subject to trauma or compression, the nerve swells and permanent nerve damage may incur. This swollen nerve is called a neuroma and often resembles a tumor. Neuromas occur commonly on the ball of the foot, usually between the third and fourth toes (Morton's Neuroma), when the nerve that passes between the metatarsals (long bones behind the toes) gets pinched and swells, forming scar tissue and an enlarged nerve. Sharp burning pain, cramping and the description of "walking on hot pebbles" is often given. The pain associated with Neuromas mimics the pain associated with stress fractures and arthritis. An x-ray can quickly decipher the fracture or arthritis, but damage to nerve tissue cannot be detected by an x-ray. The podiatrist must feel the neuroma upon examination and/or use other diagnostic tools to detect a Neuroma.
Neuromas are generally treated with cortisone injections, which shrink the swelling of the nerve, therefore relieving the pressure on the nerve. Cortisone injections generally do not cure a neuroma but offer temporary relief that may last up to several days. Orthotic therapy to control abnormal metatarsal movement, combined with cortisone injections can be a very successful course of treatment. However, if damage to the nerve is permanent, chemical destruction of the nerve or surgery to remove the nerve would be the preferred course of treatment.
Don't wear shoes that are too tight or that pinch the toes. Shoes should fit comfortably allowing the feet to "breathe" yet be well supported.