Treating Neuromas - Ten Tips

A neuroma is an inflamed nerve. In the foot, the most common place for a neuroma is between the third and fourth toes. The main nerve to your foot originates in the spine and travels down the back of the leg to the bottom of the foot and out to the toes. When the nerve becomes irritated, electrical or burning pain shoots out to the toes when walking. The second, third and fourth toes can become numb. There can be a sensation of walking on a lamp cord or a lump. Removing the shoe and massaging the ball of the foot can bring relief.

To help decrease the pain, try the following tips:

1. Rest. Every step you take aggravates the nerve. Decreasing the time on your feet will help decrease the inflammation. If you walk for exercise, try biking or swimming instead.

2. Avoid activities that aggravate the pain. Squatting, walking or running hills, climbing up and down stairs and carrying heavy items will increase the stress through the ball of the foot and irritate the nerve. Taking the stress off the nerve will help decrease the irritation, decrease the inflammation and accelerate healing.

3. Wear low-heel shoes. Any shoe (cowboy boots or high heeled dress shoes) will place excessive pressure on the ball of the foot. Keep the heel height below 1 inch.

4. Wear shoes with a wide toe box. If the toes are cramped together, this places pressure on the nerve, worsening the irritation. Your toes should have enough room to "wiggle".

5. Wear rigid shoes. Wearing flexible shoes increases the force placed through the ball of the foot. A rigid shoe with a rocker sole will decrease the pressure on the nerve.

6. Ice your foot. Placing ice of the ball of the foot for 20 minutes once or twice a day will decrease pain and inflammation.

7. Use contrast soaks. Start with 5 minutes of heat, then apply 5 minutes of ice, then switch back to heat and alternate for 20-30 minutes. Contrasting between hot and cold will help decrease the inflammation around the nerve.

8. Place a neuroma pad in your shoe. A neuroma pad (similar to a metatarsal pad) can be placed in the shoe, under the ball of the foot. The pad lifts up the bones in the foot to help decrease the pressure on the nerve. The pad should be placed behind the ball of the foot.

9. Slip inserts into your shoe. Make sure the insert you buy is an orthotic. The device should be semi-rigid to help control motion in the foot. These can be bought at your local running shop or sports store.

10. See your podiatrist. If the pain persists after taking these steps, make an appointment with your podiatrist.

Christine Dobrowolski is a podiatrist and the author of Those Aching Feet: Your Guide to Diagnosis and Treatment of Common Foot Problems. To learn more about Dr. Dobrowolski and her book visit http://www.skipublishing.com. For information on products which help treat neuromas visit http://www.northcoastfootcare.com.

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