Are your favorite Jimmy Choos causing your neuroma?

Are your favorite Jimmy Choos causing your neuroma?

A neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. A neuroma may feel as if you are standing on a pebble in your shoe or on a fold in your sock.

A neuroma involves a thickening of the tissue around one of the nerves leading to your toes. This can cause a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb.

High-heeled shoes have been linked to the development of neuromas because they cause pressure to be placed on the balls of your feet and for the metatarsal heads to be squeezed together causing the nerves in your feet to become inflamed. Over time, heels cause the achilles tendon to remain contracted even when you are not in heels, therefore, causing you to place undue pressure on the balls of your feet even while you are wearing sneakers and flats. This is called an equinus deformity in medical terms. Think of how a horse trots - on his toes - this is where the word equinus came from.

Treatment for neuromas can range from conservative to invasive. Here at Gotham Footcare I treat neuromas conservatively at first and recommend that you the patient modify shoe gear, consider orthotics to correct the biomechanics of the foot, take anti inflammatories and start a simple stretching exercise regimen. Usually these methods can help to relieve the pain caused by your neuroma. Once the pain is gone, it is important to continue with the shoe gear modification and orthotics.

If the neuroma pain continues for greater than 6 weeks I recommend an MRI to confirm the presence and size of the neuroma. Once the neuroma is confirmed, I may suggest cryosurgery to shrink the size of the neuroma. Traditional neuroma surgery involves an excision of the affected nerve which can cause significant postoperative complications. However, cryosurgery, offers a minimally invasive option that allows the patient to stay mobile while being treated. The risks are minimal compared to the traditional nerve excision, which can lead to permanent numbness in the toes. During the surgery, a tiny  incision that requires no stitch, is made within the webspace of the affected nerve. A probe is inserted under ultrasound guidance and the nerve is frozen. After the procedure, a light dressing is applied and you will be walking full weight bearing in a postoperative shoe. Most patients are out of the surgical shoe within 2 weeks and back into a sneaker. After this period, you are able to continue with your exercise regimens. After surgery, you will be given a plan tailored to you and your unique foot type that will help you to avoid another painful neuroma!

By Dr. Neha Pathak

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