Joplin’s neuroma is a rare compression traumatic neuropathy of the proper medial digital nerve to the hallux. It causes pain & tingling in the ball of the foot that radiates into the 3rd & 4th toes.
Patients seeking treatment typically report sharp pain, tingling or numbness between their toes that interfere with daily activities. Addressing this condition promptly can significantly improve comfort and quality of life.
Symptoms
A Morton’s neuroma is an enlarged nerve in the foot that causes pain & tingling (feeling pins and needles) between your toes. You may feel it when you stand, walk, or move your toes. It’s often worse when you wear shoes that rub against your toes or put pressure on the ball of your foot. It might also get better after you take off your shoes or massage your feet.
A neuroma isn’t cancer, but it’s not normal either. It occurs when your nerve tissue thickens and swells up. Your healthcare provider will examine your foot. Your doctor might put pressure on the spaces between your toe bones or ask you to move your toes around. They might also order an ultrasound test to see the enlarged nerve. This test can help rule out other conditions that cause foot pain, like a stress fracture or arthritis.
Your healthcare provider will recommend treatments that relieve your symptoms and reduce pressure on the affected nerve. You might try wearing shoes with a wider toe box or using a foot stretching device. You can also use shoe pads to cushion the area where the nerve is irritated or pressurized. Injections or cryoablation (using heat to freeze the nerve) might also be used to treat the condition. If you have a Morton’s neuroma, visit a podiatrist (provider who specializes in foot care) to see if it can be treated without surgery.
Diagnosis
Joplins Neuroma is a condition that occurs when the tissue around the nerve that runs through the inside of your big toe begins to thicken. This causes the nerve to become compressed and you can develop symptoms such as sharp pain, tingling or numbness. It is similar to Morton’s neuroma and it can be difficult to diagnose without a full assessment by a podiatrist.
It is important to identify a neuroma early as treatment is able to significantly reduce the irritation of the nerve. This includes reducing shoes that put pressure on the area and taking up the extra space with orthotics. This may also include the use of therapeutic injections or cryoneurolysis if required.
While the exact cause is not always known, there are a number of things that can increase your chances of developing a neuroma including flat feet; ill-fitting shoes; activities that require repetitive trauma to the foot (such as running or jogging); and certain foot deformities such as bunions or hammertoes. The name of this foot problem has been subject to some controversy because it is thought that the correct name for the condition should be compression neuropathy of the plantar proper digital nerve to the hallux (MPPDN). Accurate nomenclature should also consider the fact that MPPDN is not the only compression traumatic forefoot nerve.
Treatment
Getting treatment for foot pain early can reduce the risk of permanent nerve damage and help you maintain your daily activities. In general, healthcare providers recommend treatments that reduce pressure on the affected nerve, decrease inflammation, and relieve pain.
A neuroma occurs when the tissue around a nerve becomes thickened. It often causes pain between your third and fourth toes (the two middle toes closest to the big toe). You might feel like you have a pebble in your shoe or that you are stepping on a marble. You might also experience tingling and numbness in the ball of your foot or toes. A medical exam can diagnose a neuroma. Your provider will press on the spaces between your toe bones and ask you to stand or walk. They may use an imaging test called an ultrasound or an electromyography test to see how your nerve is functioning.
Your healthcare provider might recommend shoe inserts (orthotics) that support your feet and keep them in the correct position, which can help to reduce pressure on your toes. They might also suggest wearing shoes with wide toe boxes and soft, shock-absorbing soles. Some patients find relief with nonsteroidal anti-inflammatory drugs, such as ibuprofen. Ice packs can also reduce pain and swelling. If your symptoms don’t improve with conservative treatments, a doctor might prescribe corticosteroid injections into the area of the nerve.
Prevention
Morton’s neuroma is a thickening of nerve tissue in the ball of your foot, usually between your third and fourth toes. This non-cancerous growth develops when the tissue around the nerve thickens as a result of irritation or compression over time, leading to pain and tingling sensations in the foot and toes. The condition can be prevented by taking a number of simple steps to avoid placing unnecessary stress on your feet.
A good pair of shoes can significantly reduce your risk of developing Morton’s neuroma or other foot problems. Choosing footwear with a wide toe box will help ensure that your toes can move comfortably and do not get squeezed or pinched. You should also avoid wearing high heels, which can place excessive pressure on your feet and increase the chances of developing a neuroma. If you are participating in a sport that involves repetitive trauma to the feet, you should try to wear appropriate footwear and work with a trainer or coach who can help you learn how to perform the activity with proper technique.
A foot specialist can diagnose a neuroma by applying light pressure to the spaces between your toes and evaluating the way you stand and move. While a foot X-ray cannot confirm the presence of a neuroma, it can rule out other conditions that may cause similar symptoms, such as arthritis or stress fractures. Treatment options for a neuroma include conservative measures such as using an ice pack, putting a cushion in your shoe or rubbing the area with alcohol, or surgery to decompress the nerve.