What is Neuroma?
A neuroma is the term usually used to describe a swollen segment of injured nerve. The cause can be an acute injury that results in a laceration or contusion of a nerve. It can also be the result of repetitive trauma to a nerve. Less common causes are syndromic or neoplastic.
The most common neuroma is a Morton’s neuroma that usually occurs between the third and fourth toe and less commonly between the second and third toe. The bones of the toes, which produce compression, irritate the nerve. However, they can occur anywhere in the body that a nerve exists.
What are the Symptoms?
Symptoms of a neuroma are pain, burning sensation, tingling and numbness in the area of the injured nerve. Bumping, lightly tapping or bearing weight on the injured nerve can increase the symptoms. We call this a tinnel sign.
How is a Neuroma Diagnosed?
The diagnosis can be inferred based on the history and physical exam. Your physician may press or tap on the nerve to see if this produces symptoms. Your physician may order x-rays to see if any bone spurs are irritating the nerve. Occasionally, ultrasound, or magnetic resonance imaging (MRI) will be done to visualize the neuroma. Injecting a local anesthetic around the nerve can temporarily relieve symptoms and aid in diagnosis.
What is the Treatment for a Neuroma?
In the case of a neuroma caused by repetitive trauma, eliminating the trauma or wearing braces or padding to protect the nerve may help. People have reported symptom improvement with scar massage, occupational desensitization exercises or TENS treatment. Your physician may also use cortisone injections or other medicines to decrease inflammation around the nerve to try and decrease or eliminate pain.
If the neuroma is the result of a lacerated nerve, repairing the nerve will often provide relief. In other cases, where restoring continuity of the nerve is not possible, the nerve can be transferred to a segment of de-innervated muscle. Often once the nerve has somewhere to go and something to do, it will no longer cause pain. Generally 80% of patients will have an 80% or better improvement of their symptoms.