What is a neuroma? A neuroma (also called Morton's neuroma or intermetatarsal neuroma) is a very painful condition  which affects a large percentage of the population. A neuroma is a thickening of the nerve as a result of compression or irritation.   The nerve most commonly involved is between the 3rd and 4th toes as shown in the diagram on the left. Neuromas can also involve the nerve between the 2nd and 3rd, 4th and 5th, or even the nerve between the 1st and 2nd toes.

What does a neuroma feel like?

• Patients who have a neuroma usually feel a stinging, burning type of pain in the ball of the foot. Some describe the pain as a "cramp", and some say they feel "shooting" pain, or even an "electrical" sensation. The pain can be localized (just in the area between the toes) or radiate down the toe, or even up the foot and leg.
• The pain is usually episodic (comes and goes).
• Many patients say they must remove their shoe and rub their foot to get relief.
• Some patients feel a "popping" or clicking sensation, which is the nerve moving back and forth between the bones and rubbing on the ligament.
• Some patients complain it feels as if there sock is wadded up under their toes.

What Is the treatment for neuromas?

• Wear a loose fitting shoe - Early in the course of the condition, treatment consists of relieving excessive pressure on the nerve by changing shoe styles.  Wear a loose fitting tennis shoe as much as possible until the symptoms resolve.
• Oral anti-inflammatory medications are sometimes helpful.
• Cortisone injections are often effective in relieving the pain from Morton's neuroma.
• MIND Procedure - A new procedure for the treatment of neuromas is now available.  The procedure is called the minimally invasive nerve decompression (MIND) procedure.  With this procedure, a small incision is made between the toes and a series of special instrument are inserted to release the ligament between the metatarsal bones as shown in the above diagram.  This procedure gives the pinched nerve more room and relieves the symptoms in 85% of the cases. 
• Excision - In longstanding cases or in cases that have failed to respond to other methods of treatment, surgical removal of the nerve is necessary. The pinched and enlarged portion of the nerve is removed. Both the MIND procedure and removal of the nerve are done with a general anesthetic (you are asleep) on an out-patient basis. These procedures are not done in the office.