Neuroma

A neuroma is a painful condition that develops when a nerve in the ball of the foot becomes compressed or irritated, most commonly between the third and fourth toes. This thickening of nerve tissue—often referred to as Morton’s neuroma—can make every step uncomfortable. Patients frequently describe the sensation as feeling like they are standing on a pebble, experiencing sharp or burning pain, or noticing tingling and numbness that radiates into the toes.

Neuromas are often linked to repetitive stress, high-impact activities, or wearing tight or narrow shoes that squeeze the toes together. High heels, certain sports, and abnormal foot mechanics (such as flat feet or high arches) can all increase the risk. If left untreated, neuromas tend to worsen over time, making early diagnosis and treatment essential.

At Restore Foot & Ankle Specialists in Plano, Texas, Sirisha Pokala, DPM, and Gireesh Reddy, DPM, specialize in the advanced care of neuromas. We begin with a comprehensive exam, including a review of your symptoms, physical assessment, and imaging studies when needed. From there, we create a personalized treatment plan tailored to your lifestyle and goals.

Our treatment options for neuromas include:

• Custom orthotics: Designed to redistribute pressure away from the affected nerve and improve foot mechanics.

• Footwear modifications: Recommending supportive shoes with a wider toe box to reduce nerve compression.

• Activity modification: Adjustments to exercise or daily routines to reduce strain on the forefoot.

• Anti-inflammatory medications: To relieve pain and decrease swelling.

• Corticosteroid injections: Targeted relief to calm inflammation around the nerve.

• Alcohol sclerosing injections: Used in some cases to reduce nerve pain by shrinking the affected tissue.

• Shockwave therapy and regenerative treatments: Stimulating healing and reducing pain for chronic cases.

• Minimally invasive surgery: Considered only when conservative care fails, surgical options remove or release the affected nerve to provide lasting relief.

Our goal is always to use conservative treatments first and only recommend surgery if necessary. With early intervention, many patients experience significant improvement without the need for invasive procedures.

Q: What are the first signs of a neuroma?

A: Common symptoms include a sharp or burning pain in the ball of the foot, tingling or numbness in the toes, and the sensation of standing on a pebble or bunched-up sock. Symptoms usually worsen with tight shoes or long periods of standing.

Q: How is a neuroma diagnosed?

A: Diagnosis begins with a physical exam and discussion of your symptoms. Your podiatrist may press on the affected area to reproduce pain. Imaging such as ultrasound or MRI may be ordered to confirm the diagnosis and rule out other conditions.

Q: Can neuromas go away on their own?

A: Neuromas rarely disappear without treatment. Conservative therapies such as orthotics, shoe changes, and medications can greatly reduce symptoms, but professional evaluation is key to preventing progression.

Q: What kinds of shoes should I wear if I have a neuroma?

A: Supportive shoes with a wide toe box, low heels, and cushioned soles are recommended. Avoid tight, narrow, or high-heeled shoes, which place extra pressure on the forefoot.

Q: Are injections safe for treating neuromas?

A: Yes. Corticosteroid injections and, in some cases, alcohol sclerosing injections can provide effective relief when conservative care isn’t enough. Your podiatrist will determine the best option based on your symptoms and overall health.

Q: When is surgery necessary?

A: Surgery is usually considered only if symptoms persist after several months of conservative care. Surgical procedures may involve removing the affected nerve or releasing surrounding tissue to reduce pressure. Recovery times vary but are often shorter with minimally invasive techniques.

Q: What happens if I ignore a neuroma?

A: Left untreated, a neuroma can cause worsening pain, permanent nerve damage, and difficulty walking. Seeking care early gives you the best chance at long-term relief with less invasive treatment.