Ever feel like your mind is playing tricks on you? You catch a glimpse of something out of the corner or your eye, or hear a sound coming from outside, only to discover nothing there?

A neuroma in your forefoot can sometimes feel like that, although in this case it’s a very real phenomenon. Neuromas are thickened masses (benign tumors) of tissue on or adjacent to a nerve, usually located in the ball of the foot between the third and fourth toes. When you stand or walk, it may feel like a sharp pebble is trapped under your foot, but when you check your shoes there’s no rock, and when you check your feet, there’s no bump.

Other Neuroma Symptoms

In addition to pain from that trapped pebble feeling—or at least pain localized between the toes when walking—a neuroma may also result in other symptoms as a consequence of damage to the nerve. This can include a burning or tingling pain that radiates into the toes, or even periods of complete numbness in the extremities.

What Causes Neuromas?

Unfortunately, there’s no singular cause that we can point to, and in fact many cases don’t have an obvious explanation. However, a number of factors are associated with an increased risk of developing a neuroma. These include:

  • Structural foot flaws, such as flat feet. Your foot shape might create instability in the region around the base of the toes, or place extra weight or pressure there when you stand.
  • Wearing poor or ill-fitting footwear, particularly high heels and/or shoes that are too cramped at the front, as these can concentrate a lot of pressure on the balls of the feet.
  • Repetitive stresses from overuse. Certain occupations and hobbies, as well as high-impact sports or running may contribute to a neuroma.
  • Acute injuries to the forefoot.

Managing Pain at Home

If your neuroma pain is mild, you may be able to find relief at home through self-management strategies. Stick to comfortable, cushioned shoes (no heels!). Take a break for a week or so to relieve inflammation, then modify your activity routine to include lower-impact exercises (sub in some cycling or swimming instead of an extra weekly jog or pickup basketball game).

Pain that is serious or lasts more than a few days, however, should be evaluated by the team at the Kansas Foot Center.

Getting Professional Care

Our initial treatment approaches will typically be conservative in nature. Although this will not remove the thickened tissue itself, it may help you avoid surgery by slowing the progression of the neuroma and relieving pain.

In addition to the home care tips above, we may suggest using padding or taping to provide extra support and cushioning and/or better alignment at the site of the neuroma. More serious foot defects may be addressed using custom orthotics, which are specially designed to fit your fit and accommodate or correct any structural or mechanical flaws contributing to the neuroma. We also provide advanced technologies to manage pain for those that need it, such as MLS laser therapy.

Neuromas that are severe and/or do not respond well to conservative care may be removed via surgery. Although surgery is relatively simple and highly effective on average, we like to think of it as a last resort and prefer to avoid it if possible. Recovery time can vary, but is usually at least a couple of weeks.

So don’t keep standing on that imaginary pebble! If pain between your third and fourth toes is getting in the way of living a healthy, active life, please call Dr. Thomas Truong at the Kansas Foot Center for a careful examination and treatment options today. You can reach our Wichita office at 866.222.5177.

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