The thickening, or enlargement, of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates enlargement of the nerve, eventually leading to permanent nerve damage.
Anything that causes compression or irritation of the nerve can lead to the development of a neuroma. One of the most common offenders is wearing shoes that have a tapered toe box, or high-heeled shoes that cause the toes to be forced into the toe box.
People with certain foot deformities – bunions, hammertoes, flatfeet, or more flexible feet – are at higher risk for developing a neuroma. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running or court sports. An injury or other type of trauma to the area may also lead to a neuroma.
treatment is multi approach and is as follows.
1- avoid wearing high healed/pointed shoes.
2- use analgesics on as needed basis.
3- some patients get benefit from steroid injection in the painful area.
4- physical therapy.
5- Padding techniques provide support for the metatarsal arch, thereby lessening the pressure on the nerve and decreasing the compression when walking.
6- Custom orthotic devices provided by your foot and ankle surgeon provide the support needed to reduce pressure and compression on the nerve
7- Wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels.
8- Decompression surgery.
In some cases, surgeons can relieve the pressure on the nerve by cutting nearby structures, such as the ligament that binds together some of the bones in the front of the foot. it is not a major surgery and you should consider undergoing it if other available treatment options fail.
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