In the ball of the foot, the nerves lie deep down between the bones. Occasionally the bones squeeze or rub against the nerve causing it to swell. Once swollen the nerve becomes bigger and therefore more likely to be squeezed again, causing a vicious cycle of irritation and swelling. If this cycle is allowed to continue the nerve will form a fibrous capsule around it. This is called a neuroma. Neuromas will cause pain in the ball of the foot, which may radiate to one or more toes, or back up the foot. The pain is often exacerbated by tight or narrow shoes.
To treat the neuroma the cause of the irritation needs to be removed. This may involve stabilising the bones using orthotics, or spreading the bones using wider shoes or a stregically placed pad. Your podiatrist will be the best judge of your treatment plan. Ice packs, a nonsteroidal anti-inflammatory, or a cortisone injection may speed up your recovery. Very large neuromas occasionally require surgery.
A cortisone injection may cause some discomfort, but the skill and care of the injector will make a BIG difference. Murray Paton will always use a local anaesthetic and approach through the top of the foot. He may also use an ultrasound machine to guide the injection to ensure the best outcome.