A neuroma is an enlarged fibrous nerve in the front of the foot in-between the metatarsal bones (inter-metatarsal space). The deep transverse ligament runs across the metatarsal heads. The nerves run in the inter-metatarsal space underneath the deep transverse ligament and divide into two digital nerves.
The cause of neuromas remains unclear. Neuromas are more common in females but can affect anyone. Frequently they are found in the third - fourth inter-metatarsal space (50-70% of patients) with the second-third inter-metatarsal space being the next most common site.
Most patients complain of a sharp shooting pain affecting the front of their foot that radiates towards their toes. Some patients experience numbness, tingling and often describe a sensation of “walking on a stone”.
Symptoms can be initiated or made worse by wearing footwear with a narrow toe box or increased heel height, walking or driving for extended periods of time and high impact activities. Resting and removing aggravating footwear can often alleviate symptoms.
A clinical diagnosis can be made via an examination and taking a through medical history, with confirmation by an ultrasound scan or MRI.