What is a neuroma?

A neuroma is an irreversable swelling of the nerve in the foot. Neuroma pain symptoms are burning, aching pain often radiating into any of the middle 3 toes of the foot. Painful (paradoxical) numbness and "pins & needles" are very common and sometimes a "lumpy" sensation is felt under the ball of the foot, some patients state it feels like their sock is rolled up and walking on cobbles is very painful. Some temporary relief is gained by removing the shoe and massaging the foot. Tighter more fashionable shoes with higher heels will increase your symptoms by pinching the thickened nerve. Unfortunately neuromas are irreversible localized nerve damage; although this is not a condition that will spread so don't be alarmed.

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Conservative Treatment.

Cortisone (steroid) injections, can improve symptoms in 50% cases for a period of time, but can also sometimes increase your symptoms. It is more useful for early small neuromas. Orthoses (insoles), are hit and miss, and lack a robust evidence base, although some patients find them useful.

Surgical Treatment (neurectomy)

Is a definitive treatment involving the removal of the diseased portion of nerve. An incision is made along the top or sole of the foot and the affected nerve tissue is removed. You will have a large dressing for the first week after which the wound is inspected and a small, light dressing is applied. At week 2, the stitches are removed.

A final review will take place around 6-12 weeks following surgery. Graduated increase in walking is allowed after the first week. You may need between 1-4 weeks off work depending on your recovery and any complications. An area of permanent numbness often remains between the toes following the surgery, this won't affect your balance or function and hasn't been reported as a problem by patients after neurectomy. The patient satisfaction rate for this surgery is around 93% (NHS audit data of neuroma surgery undertaken by JE Hargrave).