Neuroma

The most common neuroma is called Morton’s neuroma and is characteristically found between the 3rd and 4th metatarsals of the foot. A neuroma is a swelling and thickening of the nerve, in this case it is the nerve that runs between the metatarsals and supplies the muscles, joints, and skin in the foot. Symptoms may include the sensation of a pebble in your shoe, cramping in the foot or toes, numbness, tingling, and burning sensations.  

A neuroma typically forms following chronic pressure on the nerve as a protective measure. Wearing tight shoes with a narrow toe box, having hammertoes, and playing sports that have high impact on the ball of the foot can all contribute to the development of a neuroma. Clinically, the most common treatment plan for a neuroma seeks to normalize foot mechanics and offload the affected nerve by adjustments and myofascial release in the lower extremity and pelvis first, followed by laser therapy to reduce inflammation and pain. Orthotic therapy is used in cases that require additional structural support  to allow the irritated nerve to heal. Orthotics serve to spread the metatarsals apart and maintain optimal neuromuscular coordination, reducing pressure and irritation of the neuroma.