Neuroma

What is Neuroma?

A neuroma is a painful condition, also referred to as a “pinched nerve” or a nerve tumor. It is a benign growth of nerve tissue frequently found between the third and fourth toes. It brings on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot.

The principal symptom associated with a neuroma is pain between the toes while walking. Those suffering from the condition often find relief by stopping their walk, taking off their shoe, and rubbing the affected area. At times, the patient will describe the pain as similar to having a stone in his or her shoe. The vast majority of people who develop neuromas are women.

Causes

Although the exact cause for this condition is unclear, a number of factors can contribute to the formation of a neuroma:

  • Biomechanical deformities, such as a high-arched foot or a flat foot, can lead to the formation of a neuroma. These foot types bring on instability around the toe joints, leading to the development of the condition.
  • Trauma can cause damage to the nerve, resulting in inflammation or swelling of the nerve.
  • Improper footwear that causes the toes to be squeezed together is problematic. Avoid high-heeled shoes higher than two centimeters. Shoes at this height can increase pressure on the forefoot area.
  • Repeated stress, common to many occupations, can create or aggravate a neuroma.

Symptoms

The symptoms of a neuroma include the following:

  • Pain in the forefoot and between the toes
  • Burning sensation
  • Tingling and numbness in the ball of the foot
  • Swelling between the toes
  • Pain in the ball of the foot when weight is placed on it

Home Treatment

What can you do for relief?

  • Wear shoes with plenty of room for the toes to move, low heels, and laces or buckles that allow for width adjustment.
  • Wear shoes with thick, shock-absorbent soles, as well as proper insoles or orthotics with a metatarsal pad or dome that are designed to keep excessive pressure off of the fore foot.
  • High-heeled shoes over two cm’s tall should be avoided whenever possible because they place undue strain on the forefoot.
  • Resting the foot and massaging the affected area can temporarily alleviate neuroma pain. Use an ice pack to help to dull the pain and improve comfort.

When to Visit a Podiatrist

Podiatry care should be sought at the first sign of pain or discomfort. If left untreated, neuromas tend to get worse. The podiatrists at the footinjuryclinic have been treating this condition for many years and have loads of experience

Diagnosis and Treatment

Treatment options vary with the severity of each neuroma, and identifying the neuroma early in its development is important to avoid surgical correction.

For simple, undeveloped neuromas, a pair of thick-soled shoes with a wide toe box is often adequate treatment to relieve symptoms, allowing the condition to diminish on its own. For more severe conditions, however, additional treatment or surgery may be necessary to remove the tumor.

The primary goal of most early treatment regimens is to relieve pressure on areas where a neuroma develops. Your podiatrist will examine and likely send for an ultrasound of the affected area and suggest a treatment plan that best suits your individual case.

Padding and Taping: Special padding at the ball of the foot may change the abnormal foot function and relieve the symptoms caused by the neuroma.

Medication: Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the neuroma.

Orthotics: Custom shoe inserts made by your podiatrist may be useful in controlling foot function. Orthotics may reduce symptoms and prevent the worsening of the condition.

Surgical Options: When early treatments fail and the neuroma progresses past the threshold for such options, orthopaedic surgery may become necessary. The procedure, which removes the inflamed and enlarged nerve, can usually be conducted on an outpatient basis, with a recovery time that is often just a few weeks.

Prevention

Although the exact causes of neuromas are not completely known, the following preventive steps may help:

  • Make sure your exercise shoes have enough room in the front part of the shoe and that your toes are not excessively compressed.
  • Wear shoes with adequate padding in the ball of the foot.
  • Avoid prolonged time in shoes with a narrow toe box or excessive heel height (greater than 2 centimetres).

ORTHOTICS AND SHOE INSERTS
What are Prescription Custom Orthotics?

Custom orthotics are specially-made devices designed to support and comfort your feet. Prescription orthotics are crafted for you and no one else. They match the contours of your feet precisely and are designed for the way you move. Orthotics are only manufactured after a podiatrist has conducted a complete evaluation of your feet, ankles, and legs, so the orthotic can accommodate your unique foot structure and pathology.

Prescription orthotics are divided into two categories:

Functional orthotics are designed to control abnormal motion. They may be used to treat foot pain caused by abnormal motion; they can also be used to treat injuries such as shin splints or tendinitis. At the footinjuryclinic our orthotics are manufactured in our onsite laboratory using the latest digital technology with orthema milling. The majority of our orthoses are made of a soft and comfortable EVA rubber similar to the midsole of a runner.
Accommodative orthotics are softer and meant to provide additional cushioning and support. They can be used to treat diabetic foot ulcers, painful calluses on the bottom of the foot, and other uncomfortable conditions.

Podiatrists use orthotics to treat foot problems such as plantar fasciitis, bursitis, tendinitis, diabetic foot ulcers, and foot, ankle, and heel pain. Clinical research studies have shown that podiatrist-prescribed foot orthotics decrease foot pain and improve function. Orthotics typically cost more than shoe inserts purchased in a retail store, but the additional cost is usually well worth it. Unlike shoe inserts, orthotics are moulded to fit each individual foot, so you can be sure that your orthotics fit and do what they’re supposed to do. Prescription orthotics are also made of top-notch materials and last when cared for properly. Private medical Insurance often helps pay for prescription orthotics.

What are Shoe Inserts?

You’ve seen them at the grocery store and at the mall. You’ve probably even seen them on TV and online. Shoe inserts are any kind of non-prescription foot support designed to be worn inside a shoe. Pre-packaged, mass produced, arch supports are shoe inserts. So are the “custom-made” insoles and foot supports that you can order online or at retail stores. Unless the device has been prescribed by a podiatrist and made for your specific foot, it’s a shoe insert, not a custom orthotic device—despite what the ads might say.

Shoe inserts can be very helpful for a variety of foot ailments, including flat arches and foot and leg pain. They can cushion your feet, provide comfort, and support your arches, but they can’t correct biomechanical foot problems or cure long-standing foot issues.

The most common types of shoe inserts are:

  • Arch supports
    Some people have high arches. Others have low arches or flat feet. Arch supports generally have a “bumped-up” appearance and are designed to support the foot’s natural arch.
  • Insoles
    Insoles slip into your shoe to provide extra cushioning and support. Insoles are often made of gel, foam, or plastic.
  • Heel liners
    Heel liners, sometimes called heel pads or heel cups, provide extra cushioning in the heel region. They may be especially useful for patients who have foot pain caused by age-related thinning of the heels’ natural fat pads.

Selecting a shoe insert from the wide variety of devices on the market can be overwhelming. Here are some podiatrist-tested tips to help you find the insert that best meets your needs:

Consider your health. Do you have diabetes? Problems with circulation? An over-the-counter insert may not be your best bet. Diabetes and poor circulation increase your risk of foot ulcers and infections, so schedule an appointment with a podiatrist. He or she can help you select a solution that won’t cause additional health problems.

Think about the purpose. Are you planning to run a marathon, or do you just need a little arch support in your work shoes? Look for a product that fits your planned level of activity. At the footinjuryclinic we are skilled to give you the best advice regarding your problem.

Bring your shoes. For the insert to be effective, it has to fit into your shoes. So bring your sneakers, dress shoes, or work boots—whatever you plan to wear with your insert. Let us design and customise an orthotic that will fit the contours of your shoe. Occasionally an over the counter insert will be recommended by us.

When to Visit a Podiatrist

If you are simply looking for extra cushioning or support or have been referred by a Dr, Orthopaedic surgeon or physiotherapist. If you have serious pain or discomfort, schedule an appointment with a podiatrist at the footinjuryclinic. We will assess your overall health and look for any other contributing factors. Today’s podiatrists are specially trained to evaluate the biomechanics of the lower extremity. Your podiatrist will examine your feet and how you walk. We will listen carefully to your complaints and concerns and assess the movement and function of your lower extremities. The footinjuryclinic also uses advanced technology to see how your feet function when walking or running.

The information gathered during the exam will help us determine if shoe inserts might be helpful or if you need prescription orthotics. If orthotics are needed, we will capture a three-dimensional image of each foot. Those images, as well as any measurements obtained by us, are used to create a set of unique foot supports that will improve your foot movement and lead to more comfort and mobility. Your podiatrist might also suggest additional treatments to improve the comfort and function of your feet.

The podiatrists at the footinjuryclinic are involved and participate in sport which gives us a very unique perspective when treating the biomechanics of the foot, ankle and lower leg.

The footinjuryclinic podiatrists have been treating this condition for many years and are highly experienced.
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