Neuroma, which is a pinched nerve and not a nerve tumor, is really a result of swelling from compression rather than a true growth on the nerve. Usually these are situated between the 3rd and 4th toes. Neuroma pain is characterized by sharp lancinating-type pain, usually when the patient is wearing shoes.
There is a recent paper published by Dr. Jacoby that points to the fact that at least 42% of his patients had pre-diabetic syndrome or Syndrome-X.
Neuromas usually have been surgically treated with excision but it has recently been discovered that these lesions (nerves) should not be excised. Instead, the intermetatarsal ligament should be divided. This surgical procedure allows for more space for the nerve to function and most of the time the symptoms are resolved.
It is important to recongnize that neuroma symptoms or (intermetatarsal compression neuropathy) really may be the precursor of diabetes and consultation with a phsician should be established.
Other measures to relieve neurmoa-type pain are thick-soled shoes, wider toe box, and over-the-counter remedies that include,soft insoles, foot soaks, massager products, circulation boots, and ice packs
A professional, trained in foot care, can offer many treatments for this condition. Usually an x-ray is indicated, and complete exam and history is taken. A diagnostic ultrasound can also be helpful.
The first line of treatment is usually injections of cortisone into the neuroma, mixed with a local anesthetic. This is usually carried out to a maximum of three injections. Anti-inflammatory medications such as Voltaren or Naprosyn are also used in the treatment of this condition.
If all these conservative measures fail then surgical decompression is indicated. Usually this surgery can be done under a local block (xylocaine) anesthetic, and is done on an out-patient basis. The recovery time for this procedure is usually less than three weeks and return to normal shoe gear is very rapid.
