When I am treating a neuroma for a patient I am trying to quiet down an inflamed nerve that is causing pain. The pain can be severe and often warrants fairly aggressive treatment. Other times the simplest form of treatment is all that is needed. Switching to a wider width shoe and avoiding thick socks can often eliminate symptoms from a neuroma. An open toe shoe or sandal works very well for many people with this problem. This is often done in conjunction with a short course of an anti-inflammatory medicine. If this works but not quite enough, the judicious use of a corticosteroid is often tried. I try to limit the numbers of injections given to 2 or 3. Steroid injections can be very effective in reducing the pain caused by a neuroma. Again, we are talking about a condition in some people that hurts so bad they avoid putting shoes on and have eliminated most of their activity due to the pain. Runners will stop running, dancers stop dancing and workers dread going to work. In these cases the possible benefits from an injection far outweigh possible side effects.
Recently, I have had good results with cryotherapy, the freezing of the affected nerve, which desensitizes the area thus reducing symptoms. Finally, their are those neuromas which do not respond to any of the above and hurt enough that excision is performed. The results of excision are favorable. I do the procedure at either Martha Jefferson Outpatient Surgery Center, Martha Jefferson Hospital or Augusta Health. It is a 20 – 30 minute procedure that is done with a local anesthesia and IV sedation provided by an anesthesiologist. Postoperatively rest and elevation is required for 2 weeks. This is followed by 2 weeks of decreased activity and an open toe shoe or sandal. Once successful treatment of the neuroma has taken place patients will get back to normal activity.