An Overview and Treatment of Neuroma

A neuroma is an often painful but typically benign abnormal growth of nerve tissue. It's sometimes referred to as a nerve tumor or "pinched nerve." It frequently grows between the third and fourth toes but can occur anywhere in the body.

Neuromas involve thickening of the nerve tissues, which often causes severe nerve pain. A neuroma can also mess with the way your brain interprets touch and lead to allodynia (an abnormal pain type), dysesthesia (unpleasant sensation when touched), and hypersensitivity, all of which can be painful and uncomfortable.

A lacerated (cut) nerve anywhere in the body will form a neuroma. Not all neuromas are painful, but people don't usually notice the ones that don't hurt.

A neuroma is a ball of scar tissue and axon sprouts. Axons are long threads that extend from nerve cells and conduct impulses from cell to cell. In a neuroma, however, the axon sprouts represent the nerve's attempt to heal.

The initial treatment for a neuroma is nonsurgical. Depending on where it is, some initial nonsurgical treatments of a neuroma include:

• Tricyclic antidepressants
• Anticonvulsants
• Desensitization
• Electrical stimulation
• Ultrasound
• Corticosteroid injections

Neuromas have different features depending on their locations.

Morton's neuroma is most often found between the third and fourth toes or the second and third toes. Experts think they're caused by an injury to the nerve, sometimes due to poor-fitting shoes. Women between 30 and 50 years old are most likely to develop one.

The superficial radial nerve in the hand is particularly prone to developing neuromas. The superficial radial nerve enables sensation in the back of the hand. Neuromas that affect the superficial radial nerve can be detected using the Tinel's test, where a physician taps the area over the nerve to elicit a "pins and needles" sensation.

When nonsurgical treatments for superficial radial nerve neuroma fail, the neuroma can be resected or cut off. However, a new neuroma will sprout up to take its place. A better treatment for this type of neuroma is to bury it in a muscle or bone, thus moving the neuroma to a protected place rather than near the surface of the skin where it can be bumped and irritated.

During knee arthroplasty or knee replacement, the infrapatellar branch of the saphenous nerve can be severed, resulting in a neuroma. That nerve provides feeling in the skin overlying the patella, or kneecap.