This week I saw quite a few neuromas in the office. This was more than usual so I wanted to discuss neuromas and what we can do to help patients with neuromas. I think it is appropriate to first discuss what a neuroma is then what we can do to treat them.
Neuromas seem to be more common in women than men and often present in the 4th-6th decade of life. The first symptoms often include burning and tingling with activities that can be relieved with removal of shoes and rubbing one’s feet. The neuroma itself is usually between the 3rd and 4th digits and is believed to be an enlargement of the nerve. This is the most common location as two nerves come together in this spot. The prevailing theory is mechanical stress from the adjacent bones pinch and irritate the nerve. The response is the nerves can swell from this irritation and a cycle develops.
Treatment can take many forms for a neuroma but some seem to have much better outcomes than others. I think a steroid injection is a great place to start to see if you can get the inflammation of the nerve to calm it down. Next I like to try and spread the metatarsal bones out to take pressure off the nerve. The next stop if patients continue to have been can be a series of dehydrated alcohol injections. These have great literature support and a success rate of 89%. I always make sure patients try this before removal of the nerve. Removal can be accomplished if conservative measures fail and itself is highly effective.
If you have neuroma pain I can help please call 425-391-8666 to request an appointment with Dr Brandon Nelson.
