It takes a skilled podiatrist to determine the cause of pain experienced on the bottom of the foot. The front part of the foot, just where the toes begin is commonly referred to as “the ball” or front pad of the foot. When pain or discomfort is experienced in this region it can be due to a myriad of issues; maybe it’s a neuroma.
Morton’s Neuroma (also known as Morton’s metatarsalgia or intermetatarsal neuroma) is a benign growth of plantar nerve tissue typically between the second and third metatarsals where the foot meets the toes. The problem begins when the coating of the nerve in the foot begins to thicken due to the rubbing of the two metatarsal bones. Neuromas are often a result of poor fitting shoes or abnormal bone movement throughout various areas of the foot including the metatarsals. Diabetes, injury, and substance abuse such as alcoholism can cause neuroma-like symptoms within the foot as well.
Typical symptoms of Morton’s Neuroma include numbness, pain, or the sensation of standing on a small pebble. In some cases, the pain is consistent throughout the bottom of the foot and can be felt from toe to heel.
Since there are so many causes of pain within the ball of the foot, it is crucial for a podiatrist to provide an in-depth assessment of the situation. A typical evaluation might include a look into a patient’s medical history and lifestyle practices such as diet and exercise. A history of back pain, body misalignment, and body weight, along with a direct foot examination may be necessary in investigating each patient’s case. In some instances, tests including an x-ray or magnetic resonance imaging (MRI) may be useful.
There are nonsurgical solutions to metatarsalgia. In the case of minor foot neuromas, custom made orthotics, insole cushioning, medication, soundwave therapy, and changes in footwear can help remedy the ailment. For some people surgery may need to be performed to manage and remove the built-up neuroma. Often this procedure includes a localized anesthetic of the foot and removal of the problem. Your doctor will advise you to return to normal activities within three to six weeks after surgery.
Some of the easiest things you can do if you think you have a neuroma of foot include using spacious (but snug) footwear that allows comfortable movement of the toes; typically a wider and more flexible shoe. You will probably be advised to get rid of old footwear and to avoid slip-ons and being bare foot. Your podiatrist will know what’s best for you and will determine if in fact the discomfort sensations are an intermetatarsal neuroma.