If you are experiencing a stabbing pain, burning, or numbness in the toes, you may be suffering from a neuroma.

A neuroma is a swelling and thickening of nerve tissue caused by pressure or trauma. The most common type of neuroma affecting the feet is Morton's neuroma which develops in the area between the third and fourth toes. Fortunately, neuromas are benign and treatable.

Causes of a neuroma

Anything that irritates or compresses a nerve in the feet can cause neuromas. Compression in a confined space leads to enlargement of the nerve, which can eventually cause permanent nerve damage.

High heels and narrow toe boxes
Neuromas are more common in women than men, largely because one of the most common causes of neuromas is poorly fitting shoes. Wearing high-heeled shoes or any type of shoe that has a tapered or narrowed toe box can force the toes together, compressing the nerves on all sides.

Abnormal foot structure
Abnormal foot structure can also lead to the development of neuromas. People with bunions, flat feet, and hammertoes are all at a higher risk of developing neuromas.

Injury or trauma
Trauma may also lead to neuromas. Injury from a puncture wound, laceration, or the cutting of a nerve during foot surgery can all damage the nerves, resulting in the development of a neuroma.

Neuroma symptoms

The most common symptom of a neuroma is localized pain where the nerve damage is occurring. If you have Morton's neuroma, the pain will occur in the space between the third and fourth toes. You may also experience the following in the affected area: 

• Burning sensation. 
• Cramping. 
• Sensation of something inside the ball of the foot. 
• Sensation of something stuck in your shoe.
• Sharp or stabbing pain.
• Tingling and numbness.

Symptoms associated with neuromas will appear gradually. At first, the pain may only be aggravated by wearing narrow or high-heeled shoes. The pain may go away after you remove your shoes and massage the foot. Over time, pain will become more intense and can persist for days, even weeks, without abating.

Neuroma treatment

Neuromas will respond to treatment if detected early. Mild to moderate neuromas can be treated with the following: 

• Activity modification. 
• Anti-inflammatory drugs to reduce pain. 
• Changes in shoe wear (avoid high heels and shoes with a narrow toe box). 
• Cortisone injections (to shrink swelling of the nerves). 
• Metatarsal pads (to take pressure off the nerves). 
• Orthotic devices. 
• Alcohol injections to desensitize the nerve.

If conservative treatment does not relieve symptoms, surgery may be necessary. Surgery can involve cutting the intermetatarsal ligament or removing the thickened nerve.

Your physician will be able to recommend a long-term treatment plan to keep neuroma symptoms from returning.