Pain in the Ball of your Foot? It Could be a Neuroma

Patients with neuroms suffer from one or more of the following:

 

  • Pain in the ball of the foot towards the toes
  • Occasional clicking sensation
  • Burning/numbness/tingling in the toes
  • The sensation that the sock is balled up in the shoe
The above-mentioned symptoms are consistent with a condition called a Morton’s neuroma. A neuroma occurs when tissue immediately surrounding the nerve becomes inflamed or thickened. The term “oma” usually implies a tumor, but a neuroma is not a true tumor. The nerve lies just below a ligament that connects the metatarsal heads. When the nerve is enlarged, it snaps over the ligament, causing the clicking sensation in the foot.

 

Pain occurs during weight-bearing, especially during activities that force you to bend your toes, such as gardening, frequent use of ladders or running. Pain is typically worse while barefoot or wearing flexible shoes such as slippers or flip-flops. Initially, the pain can occur sporadically and feel more like a numbness or vague discomfort. But it can progress to sharp pain that occurs with every step. Neuromas that are left untreated can cause pain for years and even can cause complete numbness in the toes.

 

The nerve most often affected is the one that runs between the third and fourth metatarsal heads (metatarsals are the long bones in the foot and the heads of the bone are what create the “ball” of the foot). The big toe is labeled as the first toe and the pinky toe is the fifth toe, so it is most often at the bottom base of the middle toes where the pain occurs. Pain is localized to the bottom of the foot or the toes and can hurt when squeezing the metatarsal heads together because it pinches the nerve. It is usually not a neuroma when pain is primarily on the top of the foot.
There are several treatment options for neuromas. Conservative treatment options consist of icing, oral anti-inflammatories, stiff-soled shoes, orthotics or a pad that goes on the shoe insert to spread the metatarsal heads apart and give the nerve more room. High heeled shoes should be avoided. The best shoe for this problem is one that does not bend at the toes such as a clog, hiking shoes/boots or certain athletic shoes. It is advised to avoid walking barefoot. If these treatments do not help, the next step is a series of steroid injections to reduce the inflammation around the nerve. The last option is surgical excision of the nerve, which leaves permanent numbness in the affected toes.

 

If you suspect you have a neuroma you should see your podiatrist to discuss the best treatment plan for you!

 

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