Have you ever felt like you're walking with a pebble in your shoe, but when you take your shoe off, there's nothing there? Or perhaps you've experienced a burning sensation between your toes that radiates into your forefoot? These symptoms often point to a neuroma, a condition that affects many people, particularly those who spend long hours on their feet. 
A neuroma isn't actually a tumor, despite its name. Instead, it's a thickening of the tissue surrounding a nerve, usually between the third and fourth toes. This thickening creates pressure and irritation of the nerve, leading to inflammation and pain. Without proper treatment from the skilled podiatrists at Rocky Mountain Foot & Ankle in Caldwell and Meridian, this condition can worsen over time, making even the simplest activities painful.
Understanding Foot Neuromas
These growths develop when the nerve tissue responds to irritation, pressure, or injury by growing abnormally. The affected nerve becomes enlarged and inflamed, often creating a nodule that can be felt when examined by a skilled foot specialist. A neuroma typically occurs at points where the nerve branches or where it passes close to bones and ligaments in the foot.
Neuroma pain has a distinct pattern that many of our Caldwell and Meridian patients describe vividly: sharp, burning sensations that begin mildly and worsen gradually. Some experience electric shock-like pain that shoots into their toes, while others feel numbness or strange tingling sensations. These symptoms typically worsen when walking barefoot on hard surfaces or when wearing tight-fitting shoes, and they often improve temporarily when your foot is rested and massaged.
Left untreated, neuromas don't simply go away. The irritated nerve continues to thicken, creating a cycle of inflammation and pain that becomes increasingly difficult to resolve without professional intervention. This is why the experienced podiatrists at Rocky Mountain Foot & Ankle emphasize early diagnosis and prompt treatment to prevent long-term nerve damage and chronic pain issues.
Types of Neuromas
Neuromas develop in various locations in your foot, and each has different characteristics and symptoms. After a thorough examination, our podiatry team regularly diagnoses and treats several growths:
- Morton's neuroma. Also referred to as an interdigital neuroma, this is the most common type. It occurs between your third and fourth toes, and it often feels like you’re standing on a fold in your sock or a pebble in your shoe. Pain typically builds gradually, starting with discomfort only while wearing shoes but then progresses to persistent pain.
- Intermetatarsal neuroma. This growth develops between any of the metatarsal bones in your foot. While similar to Morton's neuroma, it can appear in different locations and may cause symptoms that spread across a wider area of the foot.
- Joplin's neuroma. Less common but still treated by our Caldwell and Meridian podiatrists, this neuroma affects the outer side of the foot—specifically, the plantar proper digital nerve that runs between the fourth and fifth toes. This condition is sometimes referred to as entrapment neuropathy.
- Traumatic neuroma. A thick growth might also develop after an injury or surgery that damages a nerve. The nerve attempts to heal but instead forms scar tissue that creates pressure and pain.
Typical Causes of Neuromas
Your feet endure tremendous stress each day, but certain situations dramatically increase the pressure on the nerves in your forefoot. At Rocky Mountain Foot & Ankle, our Caldwell and Meridian foot doctors notice that patients commonly develop neuromas after specific activities or circumstances that place excessive strain on these sensitive structures including, but not limited to:
- Improper footwear. High-heeled or narrow-toed shoes compress your toes together, putting pressure on the nerves between your toes.
- Foot structure. Certain foot types, such as high arches or adult flat feet, can make you more susceptible to developing neuromas due to instability when walking.
- Repetitive stress. Activities that place repeated pressure on the forefoot, such as running or court sports, also greatly irritate the foot nerve.
- Occupational factors. Jobs that require long periods of standing or walking on hard surfaces put additional stress and strain on your feet.
5 Key Signs of a Neuroma That Indicate It’s Time to Visit Rocky Mountain Foot & Ankle
Early intervention is key to successful neuroma treatment. Contact our Caldwell or Meridian offices if you experience:
- Persistent pain in the forefoot, especially between the toes, that doesn't improve with rest.
- Tingling or numbness in the toes that interferes with daily activities.
- The sensation of walking on a pebble or having a fold in your sock when there's nothing there.
- Pain that worsens when wearing shoes or when engaging in certain activities.
- Symptoms that have lasted more than a few days or that come and go but are getting progressively worse.
How Our Detailed Idaho Podiatrists Diagnose Neuromas
Our goal is to help you regain pain-free mobility and return to your activities as soon as possible, so we conduct a thorough consultation that includes many aspects.
Physical Assessment
We’ll examine your foot closely, applying pressure to different areas to identify the precise location of pain. We’ll also look for masses or tender spots between your toes and test for sensory changes by lightly touching different areas and asking you to report whether you feel the touch and if it's the same on both feet.
During this examination, your doctor may perform a Mulder's sign test, in which they squeeze the forefoot while simultaneously pressing between the metatarsal heads. A positive test often produces a painful clicking sensation as the neuroma moves between the metatarsal bones.
Medical History Review
We'll discuss your symptoms, when they began, what activities make them worse, and any factors that might contribute to your condition. This detailed history helps identify patterns that point to neuroma development rather than other foot conditions with similar symptoms.
Imaging Tests
While neuromas don't always appear on standard X-rays, our foot and ankle specialists may order ultrasound or MRI scans to rule out other conditions and confirm the presence and size of a neuroma. Our Caldwell and Meridian offices use ultrasound technology which is particularly useful for visualizing soft tissue structures and can often detect neuromas as small as 3mm in diameter.
When needed, we refer patients for MRI scans, which provide even more detailed images to help distinguish neuromas from other soft tissue masses, such as ganglion cysts or foreign bodies.
Differential Diagnosis
The foot specialists at Rocky Mountain Foot & Ankle are careful to rule out other conditions that mimic neuroma symptoms, such as arthritis, stress fractures, or tendonitis. This thorough approach ensures you receive the most appropriate treatment for your specific condition rather than a generic solution that might not address the true cause of your pain.
Effective Neuroma Treatments From Rocky Mountain Foot & Ankle
Our approach to treating neuromas begins with conservative methods whenever possible, tailored to your specific medical issue. Depending on what your examination reveals, our recommendations might include:
- Footwear modifications. Wearing shoes with a wider toe box and lower heels can reduce pressure on the affected area.
- Custom orthotics. These specially designed shoe inserts help redistribute pressure away from the neuroma. We create custom orthotics at our Caldwell and Meridian locations that address your particular foot structure and the location of your neuroma.
- Padding and taping. Strategic padding helps separate the bones to prevent them from irritating the nerve. Your podiatrist shows you how to tape your foot to provide additional support.
- Medications. Anti-inflammatory drugs can reduce pain and swelling. In some cases, our podiatrists may administer corticosteroid injections to provide more significant relief from inflammation.
- Physical therapy. Specific exercises can strengthen the foot muscles and improve flexibility, potentially reducing pressure on the affected nerve.
- Surgical options. When conservative treatments don't provide adequate relief, our skilled foot surgeons can perform procedures to remove the affected nerve tissue or release pressure on the nerve. These procedures are typically performed on an outpatient basis with minimal recovery time.
In the Treasure Valley's beautiful outdoors, staying active is a way of life. Hiking the foothills around Boise, skiing at Bogus Basin, or walking the greens of Purple Sage Golf Course all contribute to overall health and well-being, but they also put extra stress on our feet.
Don't wait until neuroma pain becomes unbearable and prevents you from enjoying the activities you love. With early intervention and proper treatment, the skilled podiatrists at Rocky Mountain Foot & Ankle help you regain quality health.