Dr. Vincent Giacalone
Podiatric Medicine & Surgery
466 Hook Rd., Suite 24D, Emerson, NJ 07630
A neuroma is a painful condition, also referred to as a “pinched nerve”, Mortons neuroma or a nerve growth or swelling. It is a benign, non-cancerous, growth of nerve tissue frequently found between the third and fourth toes or the second and third toes, that brings on pain, a burning sensation, tingling, or numbness between and around the toes and on the ball of the foot.
The main symptom associated with a neuroma is pain between the toes while walking, however symptoms may vary. Those suffering from a neuroma often find temporary 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 the shoe or part of their sock stuck between the toes.
What are the symptoms?
- Pain in the forefoot and between the toes.
- Tingling and numbness in the ball of the foot or toes.
- Swelling between the toes.
- Pain in the ball of the foot when weight is placed on it or in shoes.
How do you get a neuroma?
- 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 feet or a flat feet, 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 are problematic.
- Repeated stress, common to many occupations, can create or aggravate a neuroma.
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 and proper insoles that are designed to keep excessive pressure off the foot.
- High heels should be avoided whenever possible because they place undo strain on the forefoot and can contribute to a number of foot problems.
- 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.
- For a simple, undeveloped neuroma, 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, podiatric medical treatment or surgery may be necessary to treat or remove the neuroma.
What are the treatments for a Neuroma?
Treatment options vary with the severity of the neuroma, and identifying the neuroma early in its development is important to avoid surgical correction. Treatment should be sought at the first sign of pain or discomfort; if left untreated, neuromas tend to get worse. The primary goal of most early treatment regimens is to relieve pressure on areas where a neuroma develops. Dr. Giacalone will examine and likely X-ray the affected area and suggest a treatment plan that best suits your individual case.
Padding: Special padding at the ball of the foot may change the abnormal foot function and relive the symptoms caused by the neuroma.
Medication: Oral anti-inflammatory medications and cortisone injections can be used to ease acute pain and inflammation caused by the neuroma.
Orthotic Devices: Custom shoe inserts made by a lab may be useful in controlling foot function. An orthotic device may reduce symptoms and prevent the worsening of the condition.
Injections: A series of up to three cortisone injections, at bi-weekly intervals, into the area may be useful in reducing the pain, temporarily or permanently. A special type of dehydrated alcohol injection may be used in an attempt to destroy the nerve. Alcohol injections are given weekly over the course of 6-8 weeks, however this treatment is not as successful as cortisone injections.
Surgical Option: When early conservative treatments fail and the neuroma progresses past the threshold for such options, 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. Dr. Giacalone will thoroughly describe the surgical procedures to be used and the results you can expect.
Remember that foot pain is not normal, and any disruption in foot function limits your freedom and mobility. It is important to schedule an appointment with Dr. Giacalone at the first sign of pain or discomfort in your feet, and follow proper maintenance guidelines to ensure their proper health for the rest of your life.
Dr. Giacalone has been trained specifically and extensively in the diagnosis and medical and surgical treatment of foot disorders. Dr. Giacalone has been board certified by The American Board of Podiatric Orthopedics and The American Board of Podiatric Surgery since 1993 and 1995 respectively and is a Fellow of the American College of Foot and Ankle Surgeons. Dr. Giacalone performs surgery at Hackensack University Medical Center in Hackensack, Hackensack University Medical Center @ Pascack Valley in Westwood and Surgicare Surgical Center in Oradell.