What Is An Intermetatarsal Neuroma?
An intermetatarsal neuroma (IMN) is any irritative process of the common digital (toe) nerve branch that supplies the plantar (bottom) to the adjacent toes. It most frequently involves the nerve that supplies sensation to adjacent sides of the third and fourth toes, but can also affect other toes of the foot. A neuroma is not cancerous and is not a true tumor but a reactive, degenerative process such as a scar. Therefore, a neuroma is a benign enlargement of the nerve.
Besides pain, you may also experience numbness and burning of your foot. Symptoms are aggravated by walking in shoes and relieved by removing shoes, resting and massaging the foot. Pain that occurs at rest may suggest that the neuroma is worsening.
Intermetatarsal neuroma occurs in all adult age groups and is most prevalent among females. There are several factors that contribute to the occurrence. High-heeled shoes, trauma, inflammatory conditions such as arthritis, and repetitive trauma from stresses incurred in occupational and recreational activities are several of these factors. Any conditions that cause constriction or irritation of the nerve can lead to the development of an intermetatarsal neuroma.
Classic symptoms include pain with walking. This pain may manifest itself as burning, shooting, stabbing or radiating. Relief of pain by removing the shoes and massaging the area is another typical symptom. A movable mass reacting to touch that is painful is a strong sign of a neuroma.
The goal of treatment is to reduce or eliminate symptoms, so that you can maintain your normal lifestyle. Treatment may be surgical or non-surgical. Non-surgical treatment is often attempted before surgical intervention. Conservative treatment for an intermetatarsal neuroma usually includes modifying shoes, orthoses or arch supports and/or cortisone infiltration. These conservative therapies may provide complete, partial or no relief of symptoms. The decision to surgically intervene is based on your symptoms. A neurectomy or surgical removal of a neuroma is performed when conservative treatment proves ineffective.
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