Neuromas: A Pinched Nerve in the Ball of Your Foot

April 9, 2011

What Causes a Neuroma?
Wearing tight or high-heeled shoes can cause a neuroma. Shoes that are too narrow or too pointed squeeze the bones in the ball of the foot. Shoes with high heels put extra pressure on the end of the bones. When the bones are squeezed together, they pinch the nerve that runs between them.

Symptoms
The most common symptom of a neuroma is pain in the ball of the foot between two toes. The pain may be dull or sharp. It may feel as if you have a stone in your shoe. You may also have tingling or numbness in one or both toes. Symptoms may occur after you have been walking or standing for for a while. Taking off your shoes and rubbing the ball of your foot may relieve the pain.

Diagnosis and Treatment
Your doctor diagnoses a neuroma by checking you foot. Treatment may include wearing wider shoes, soaking or icing the foot, and putting a special pad in your shoe. You may also be given medication. These steps most often relieve the pain. If not, your doctor may suggest surgery to cut the ligament or remove the nerve.

Physical Exam
Your doctor will ask you what your symptom are and when they occur. He or she will also squeeze the ball of your foot to check for tenderness and pain. Be sure to tell your doctor where the pain is. You may also have x-ray to rule out a fracture or arthritis.

Treatment
To take pressure off the nerve in your foot and relieve the pain, your doctor may suggest one or more of the following treatments:

  • Shoes – Wear well-cushioned, low-heeled shoes. Make sure shoes have plenty of room across the ball of the foot and toes.
  • Contrast Baths – To reduce swelling in the nerve, soak the foot in warm water for 30 seconds. Then soak it in cool water for 30 seconds. Go back and forth for 5 minutes. Do this 3 or 4 times a day.
  • Metatarsal Pads -The metatarsal pad pushes the bones in the ball of the foot apart. This keeps the bones from pinching the nerve.

Medication
Your doctor may suggest an oral anti-inflammatory medicine, such as ibuprofen, to help reduce swelling. If this and other treatments don’t relieve your pain, your doctor may inject cortisone around the nerve.

Inside the Ball of Your Foot
The ball of your foot is the bottom part just behind your toes. Bands of tissue (ligament) connect the bones in the ball of your foot. Nerves run between the bones and underneath the ligaments. A nerve may become pinched between the end of a bone and a ligament. This causes the nerve to swell and become painful. The painful, swollen nerve Is called neuroma. A neuroma most often occurs at the base of either the third and fourth toes or the second and third toes.

Preventing Future Problems
To prevent future neuroma, buy shoes with plenty of room across the ball of the foot and in the toes. This keeps the bones from being squeezed together. Wearing low-heeled shoes also puts less pressure on the bones and nerves in the ball of the foot.