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Knowing Pain like the Back of Your Foot

Posted on: 11/30/1999
Hushpuppies pestered by a painful neuroma may be anything but hushed. In fact, they may scream for attention! Interdigital neuroma is a medical term for a painful growth that sometimes occurs between two toe bones, usually of the third and fourth toes.

The problem stems from scar tissue that grows around and squeezes a small nerve that runs between the toes (the interdigital nerve). Women seem to be most affected by this condition, which typically starts after age 50. Tight and narrow shoes often make the pain worse.

This study is the first of its kind to look at the long-term benefits of neuroma surgery. The study considered the results of 66 people (74 neuromas) who had neuroma surgery. The preferred method of surgery is to make a small incision on the top of the foot, just over the neuroma. A ligament that crosses over the neuroma is divided, and the small nerves passing between the toes are severed.

Past studies done shortly after surgery suggest that the benefits of surgery worsen with time. Yet this study showed that 85 percent of all patients had either "good" or "excellent" satisfaction an average of five and a half years after surgery. Even though some patients still had some numbness or tenderness, it didn't keep most of them from doing normal activities. Twenty-three people had mild problems resuming activities. Only two had major restrictions on what they could do.

The benefits observed by these authors have a firm, long-term footing. Surgical treatment of a painful neuroma through the top of the foot shows successful results more than five years later.

References:
Michael J. Coughlin, MD, and Troy Pinsonneault, MD. Operative Treatment of Interdigital Neuroma: A Long-Term Follow-Up Study. In The Journal of Bone and Joint Surgery. September 2001. Vol. 83-A. No 9. Pp. 1321-1328.

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