A neuroma is typically a benign thickening of the nerve that develops along the plantar surface near the ball of the foot. It will most commonly affect the space between the second and third or third and fourth metatarsals. The thickening is usually as a result of compression and irritation of the nerve causing enlargement and even permanent damage to the nerve. Most people will develop pain, tingling or burning, or even the sensation that your sock is all wadded up in the shoe.
Before treatment can begin, your podiatrist will perform a thorough history and physical examination, and likely order X-rays and possibly advanced imaging studies such as an ultrasound or MRI to confirm this diagnosis. Advanced imaging is often necessary as the metatarsophalangeal joint capsule just adjacent to the neuroma on either side can also be inflamed (capsulitis) and cause similar symptoms. Treatment for this problem is divided into two categories: surgical and non-surgical.
Non-surgically, your podiatrist can recommend icing, adding padding to your shoes, activity or shoe gear modifications, custom orthotics and possibly oral medication for inflammation. An additional non-surgical treatment that will likely be offered is injection therapy. The injection will likely consist of a local anesthetic as well as a steroid. Surgically your podiatrist would suggest excision of the neuroma if other treatment options have failed.