Neuromas of the foot are not only the 2nd most common problem see in a podiatrist’s office but are they can become so painfull that they are one of the most frequent foot conditions treated surgically.
Neuromas are inflamed, enlarged intermetatarsal nerves found between the 2nd and 3rd or 3rd and 5th metatarsals on both feet. They are benign in nature but create nerve pain including sharp, burning, shooting pain during walking and ambulation. They can become so painful that they require the patinet to get off of their feet and rub the area before they can resume weight bearing.
They are caused by a constant irritation of the intermetatarsal nerve with the adjacent metatarsal bones during weight bearing activity. Improper foot function with collapse of the three arches of the foot is believed to cause the contact between the nerve and metatarsal bone.
Treatment options are many. One of the first changes made by many women patinet’s is to stop using high heeled shoes, as this puts additional forces and pressure on the metatarsal area and escalates the pain. After a period of time, even full time use of flat shoes, fails to eliminate the pain. Anti-inflammatories, pain meds, injections can sometime mask the symptoms but are temporary and quickly become innefective. Alcohol injections and surgical excision attempt to destrol the nerve and therby resolve the painfull symptoms. Metatarsal pads, supportive shoes, cushion and orthotics all attempt to reduce the bone on nerve contact as we stand and are attempts to address the cause of the neuroma. Unfortunatly complications associated with attempts to destrol the involved nerve are many and the long term results of these very expensive and invasive procedures fail more than 50 percent of the time.
Even devices that address the cause, by changing arch function, will fail if they do not relieve sufficient pressure between the nerve and the bone. Many patients get some partial relief of symptoms with these treatments. Unfortunately most of these devices do not relieve sufficient pressurel to adaquately resolve the symptoms of this disabeling condition.
Research with theta has identified the corrective design of any foot control device that is intended to change foot function and reduce the pressure caused by arch function. Clinical treatment with thousands of neuroma patients indicate that even though some reduction in symptoms may be observed with correction levels as low as 10 degrees, 70 percent of all patients require 30 to 40 degrees of correction in order to become pain free. Even patients with a previous history of unsuccessfull surgery will respond to higher levels of theta correction.
After 25 years as a Podiatric Surgeon I now reccomend treatment with Theta before ANY surgery is considered, this treats the cause so effectively, that re-growth, scar formation, infection, stump neuroma, or new growth of neuromas in any of the 4 different interspaces can be avoided. Brent A Jarrett DPM (Podiatric physician and surgeon)