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A neuroma is a swelling of a nerve that is usually caused by the nerve becoming trapped. The most common form is foot neuroma, or as it is commonly termed, Morton’s neuroma. Foot neuroma can be a very painful condition that requires careful management that includes lifestyle changes to avoid a recurrence.

What is foot neuroma?

Foot neuroma is defined as a benign swelling of the medial plantar nerve in its third main digital branch.

The medial plantar nerve is the nerve that runs across the bottom of your foot. It connects via 2 sub-branches to the spaces between your toes. It has 3 digital branches: one for the space between your big toe and your second, one for the space between your second and third toes, and one for the area between your third and fourth toes. Usually the affected nerve branch is the one between your third toe and your fourth so the pain arises in the sole of your foot just before the division between your third and fourth toes. Foot neuroma can be unilateral, affecting only one foot, or more rarely bilateral, affecting both feet.

Although foot neuroma usually affects the space between the third and fourth toes, it can affect any of the spaces. It rarely affects 2 spaces within the same foot simultaneously. Foot neuroma may cause just numbness in the sole of the foot but other people affected by it experience excruciating pain – sometimes likened to walking on a sharp pebble. The pain may spread to other regions of the foot.

What are the symptoms of foot neuroma?

Symptoms of foot neuroma include:

  • Tenderness or numbness: this is usually immediately behind your third and fourth toes but may be behind other toes.
  • Pain: the pain may be sharp, as in walking on sharp stones, or burning. You may also feel a tingling sensation. The pain may spread to other, or indeed all, regions of your foot. The pain is especially present in the sole and other weight-bearing areas of your foot. At the extreme, the pain may comprise ‘electric shocks’ to your foot that wake you from sleep.

Symptoms tend to become increasingly severe over time if the foot neuroma is untreated. They may appear and disappear for no apparent reason.

What causes foot neuroma?

A foot neuroma is the body’s response to protect the nerve from injury. So, although the precise cause is uncertain, anything that regularly compresses or otherwise stresses the toes and foremost regions of the foot may cause foot neuroma.

Who is at risk of foot neuroma?

People who put excess stress, especially compressive stress, on their feet are at risk of foot neuroma. Those at particular risk include:

  • People who wear uncomfortable footwear: high heels, shoes with narrow toecaps, or both.
  • Most athletes: people who frequently jog, sprint or run place abnormal stress on the soles of their feet, hence most athletes are at risk of foot neuroma.
  • People with an unusual gait: foot deformities such as bunions exacerbate the risk of developing foot neuroma.
  • People who are otherwise unhealthy: anyone who has a weakened immune system or who is obese is at risk. Diabetics may be especially at risk.

How do I prevent foot neuroma?

Wearing comfortable footwear is a good way to avoid foot neuroma. Exercise regularly but do so sensibly. Walking doesn’t place extreme stress on the body, so is superb exercise; you may also consider swimming if you are affected by foot problems. This is good exercise that puts no pressure on the feet. If you have corns, bunions or other foot problems, have them treated promptly as these may cause an unusual gait and so lead to foot neuroma.

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