Life is full of stress and pressure. Sometimes, a little stress is a good thing. If we never tested the muscles in our arms by lifting something, the muscles would never expand and get stronger. They could even atrophy to the point where we can hardly lift any weight at all. When the pressure is on the nerves between your toes, however, the outcome is not always so positive. The tissue may grow and thicken to protect itself, forming a neuroma. This can end up putting so much compression on the nerve that it ceases to function as it should.

Identifying the Pressure Source

A common place for such a nerve “tumor” or growth is between the base of your third and fourth toes. When it occurs there, it is referred to as Morton’s neuroma, after the 19th century doctor who identified and studied this particular condition extensively.

Several issues are seen as contributing factors to this thickening of the tissue. One is shoe choice. Any shoe that pinches the toes together at the front can stress the nerve between them and cause it to expand. High heels that shove the foot forward into a tight toe can also be a factor. If your foot structure has a predisposition to developing bunions, you may be more prone to developing this growth as well.

Sometimes the nerve is affected by damage in an accident, or trauma from a job that involves repeated pressure on that part of the foot, such as standing on ladders, kneeling with your toes bent (as in gardening), or settling on the ball of your foot a lot (think baseball catchers).

Noting the Symptoms

What does a neuroma feel like? Some have compared it to a sock bunched up under your foot, or like you are standing on a thick coin. Others speak of swelling or numbness and pins-and-needles in the ball of the foot, and still others of pain there when walking, or an ache that reaches into the toes.

These symptoms may appear while you are on your feet, and go away again when you rest. You may be able to relieve the discomfort and numbness by massaging the area or stopping for a few minutes before moving on. If you don’t do anything, it may gradually get worse, until it hurts even when at rest. The thickening may also become permanent, leading to chronic problems.

Finding Pain Solutions

If you come in to Austin Foot and Ankle Specialists for a consultation, Dr. Craig H. Thomajan DPM, FACFAS may be able to see or feel the nerve growth externally. We will ask you questions about when the pain began, what makes it worse, and what kind of work or activity you do. We may evaluate your footwear and your gait—the movements of your feet and legs as you walk. These will all give us clues as to what is causing the problem and what can be done to remedy it.

Catching a neuroma in the early stages will give us more options for treatment and a better chance of keeping a full-fledged problem from developing. Conservative treatment may include padding, icing, modifying your shoes, changing your activities, medications or injections, or designing custom orthotics to correct any gait abnormalities. In serious cases, surgery is a final option if other methods do not relieve your discomfort.

At the first sign of thickness or pain between your toes or in the ball of your foot, call us at (512) 328-8900 and set up an appointment in one of our offices in the Greater Austin Area. You may also request one online. Our expert staff is redefining podiatric care with the latest treatment methods and expertise in forefoot surgery. Don’t delay: get help today!


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