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People who usually wear tight, narrow, high-heeled shoes run the risk of developing a thickened, swollen nerve at the ball of the foot. This condition is called Morton's neuroma, which causes intense pain when they walk. A nerve runs along the foot between the toes, and when this gets squeezed for a long period, it may get swollen and develop into a neuroma, or a benign (not cancerous) growth near the bases of the toes. Aside from using poorly fitting shoes, other factors that may lead to compression of the nerve in the ball of the foot include high impact sports such as jogging and rock-climbing, as well as the presence of other foot deformities such as bunions, high arches, flat feet, or hammertoes.

Symptoms include a sharp pain that is increased when walking and using tight shoes, tingling, or numbness. It is best to see a doctor when the symptoms do not improve even when you rest or change your shoes.

Treatment of Morton's Neuroma

Conservative treatments for foot neuroma includes using well fitted, soft-soled shoes that allows enough room for the toes, and avoiding pointed, tight or narrow shoes. Reducing activities that put pressure on the ball of the foot helps relieve pain. Foot pads and arch supports may also reduce pressure and improve symptoms. These devices are available over-the counter from drugstores, but you can also ask your doctor to prescribe custom-made shoe inserts for your foot. Physical therapy may involve deep tissue massage and stretching exercises for the foot.

Acute pain may be relieved by applying an ice pack on the affected area of the foot for about 15 minutes. Over-the-counter pain relievers such as ibuprofen or naproxen may be used to reduce inflammation. You can also massage the foot around the affected area to relax the foot. If these do not work, your doctor may recommend local steroid injections to reduce swelling, inflammation and pain.

Surgical treatment for Morton's neuroma may be done to decompress the area around the nerve. If this does not work, the doctor may remove the thickened nerve, but this can result in numbness of affected toes. The outlook or prognosis of surgery also depends on how badly damaged is the nerve.

Aside from the common complications associated with most surgeries such as wound infection, bleeding, and scarring, one of the complications of surgery for Morton's neuroma is the development of a stump neuroma, which occurs when there is irritation of the end of the cut nerve. Symptoms include pain that is similar, or may be worse than the original pain. A second surgery may be required to remove the recurrent neuroma if conservative measures such as shoe modification or steroid injections do not improve the symptoms.

Studies show that conservative therapy results only in up to 30% success rates, while surgical intervention can result in up to 95% satisfactory outcomes.

Alternative treatments include extracorporeal shockwave therapy and percutaneous radiofrequency ablation.

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