A neuroma is a benign tumor of the nerve. However, in most cases, it is an inflammation of the nerve with a thickening of nerve tissues that may develop in various areas of the foot. The most common neuroma in the foot is Morton’s neuroma. This occurs between the third and fourth toes (bases of). It is sometimes referred to as an inter metatarsal neuroma.
The thickening or enlargement of the nerve is thought to be the result of compression and irritation of the nerve. It can get displaced under the bone and even trapped in fibrous, scar like tissue. Even though it can be palpated, it doesn’t always mean it is painful.
However, if it is palpable, something is probably wrong mechanically as something is irritating the nerve. When it does become painful or symptomatic, you will know it. Over the years, you name the symptom, I have probably heard it: throbbing, aching, burning, electrical, stinging. I have also heard, “I stepped down and felt a knife in and out of my foot,” ” I have to take my shoe off and rub it, there is a marble growing between my toes,” etc..
People with higher arches and other deformities are at a higher risk for developing a neuroma(s). Treatment can vary as much as the symptoms. A metatarsal pad, wider shoes, etc. in my experience are a 50-50 chance. One simple treatment for a neuroma is massaging. This loosens the surrounding tissues and increases blood flow for healing.
Side Note: Of course, one should not wear shoes too narrow. However, a patient once told me the neuroma felt better the tighter the shoe was. This is due to the shoe re-positioning the bones and joints into a more supinated position like an orthotic may do.
In order to have a higher success rate, it is important to get at the cause of the irritation. I have found that utilizing custom functional foot orthotics, along with simple to advanced physical therapy modalities, will address what is causing the irritation. The orthotics should be coordinated with the appropriate shoe based on your foot type, ideal fit and needs. Improve the osseous (bone and joint) alignment as well as muscular function begets less irritation to the nerve.