Chronic Pain Types What Is a Neuroma? Abnormal Nerve Tissue That Causes Severe Pain By Erica Jacques Erica Jacques LinkedIn Erica Jacques, OT, is a board-certified occupational therapist at a level one trauma center. Learn about our editorial process Updated on November 07, 2022 Medically reviewed by Alexis Appelstein, DO Medically reviewed by Alexis Appelstein, DO Alexis Appelstein, DO, is board-certified in anesthesiology and provides general anesthesia in a private practice. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Symptoms Causes Diagnosis Treatment Prevention A neuroma—a.k.a. a nerve tumor or "pinched nerve"—is an often painful but typically benign abnormal growth of nerve tissue. Neuromas can occur anywhere in the body. A common type of neuroma in the foot, called Morton's neuroma, grows between the third and fourth toes. The hand is another common site for a neuroma to develop. This article explains neuroma symptoms and their causes. It presents information about when you may want to see a healthcare provider for a possible diagnosis and neuroma treatment. ljubaphoto / Getty Images What Are the Symptoms of a Neuroma? Neuromas involve thickening of the nerve tissues, which often causes severe nerve pain. A neuroma can also change the way your brain interprets touch and lead to pain types categorized as dysesthesias. Dysesthesias are defined as abnormal sensations. These can be painful or just unpleasant, although that distinction can be hard to make. Neuromas are associated with two types of dysesthesias, both of which cause often significant pain: Allodynia: This is pain from stimuli that shouldn't cause pain, such as a light brush of fabric against the skin, moderate heat or cold, or a small amount of pressure from a waistband that's not too tight. Hyperalgesia: A heightened feeling of pain from stimuli that is normally painful. For example, bumping a body part against a door jamb might normally be a three or four on the pain scale, but a six or seven for someone with hyperalgesia. More specific symptoms depend on the region of the body where the neuroma forms. In Morton's neuroma, symptoms include: Burning pain in the ball of the foot that may radiate into the toesSharp, tingling pain that intensifies with activityPain that's exacerbated by wearing shoes, especially if they're tight or narrowNumbness or unpleasant sensationsClicking sensation when you walkPain after taking off shoes People with neuromas are at risk for developing pain in a larger area from something called complex regional pain syndrome (CRPS). This usually develops over time, but can also happen post-surgery. CRPS can lead to additional symptoms in nearby tissues and structures, such as: Changes in circulation and sweat productionChanges in hair densityDecreased bone density Typically, these symptoms will improve when the neuroma is successfully treated. When to See a Podiatrist People living with a Morton's neuroma may need to see a foot specialist called a podiatrist. Pain that doesn't go away, or that affects daily activities, should be diagnosed and treated by a healthcare provider. A neuroma won't go away on its own but in more than 80% of cases, nonsurgical treatment will relieve pain. An Overview of Morton's Neuroma Causes The neuroma is basically a ball of scar tissue and long threads called axons, which form as the nerve attempts to heal. Not all neuromas are painful, but people don't usually notice the ones that don't hurt. Neuromas are caused by injuries to a nerve, which can be a laceration (cut), a crushing injury, nerve compression, or an excessive stretch. Common causes include: Surgery, especially limb amputations, mastectomy, or hernia repairCertain shoe styles—be them tight, high-heeled, pointed, or ill-fitting—that affect the foot and its natural alignmentFlat feet or other genetic abnormalitiesBunionsRepetitive stressPregnancyIllnesses such as rheumatoid arthritis or gout When neuromas form after surgery, it can cause pain to persist long after the expected surgical healing time. This can lead to chronic postoperative pain. While neuromas are often associated with amputations, they don't cause phantom limb pain. However, they can make it difficult or impossible to wear a prosthetic. Diagnosis To diagnose a neuroma, your healthcare provider will ask you about your symptoms and perform a physical exam. Often, they'll do what's called Tinel's test, which involves tapping over the path of the nerve to see if it causes pain or tingling. Depending on the location of the suspected neuroma, they may also feel for a distinctive lump in the painful area. You may also be sent for imaging. An X-ray can help rule out other potential causes of pain, and ultrasounds are good at spotting neuromas. Magnetic resonance imaging (MRI) is sometimes used, but it can lead to false-positive results and is much more expensive than an ultrasound. Healthcare providers sometimes use a nerve block as well, which means they inject an anesthetic at the site of pain or along the known pathways of nerves believed to be involved. If it alleviates the pain, that confirms the diagnosis. Temporary or Permanent Nerve Block for Chronic Pain Treatment The initial treatment for a neuroma is nonsurgical and may involve medications, physical therapy, or both. Common medications for neuroma include: Tricyclic antidepressants, such as Elavil (amitriptyline): These drugs change how the central nervous system processes pain signals. For neuromas, they can provide some relief from burning and tingling. Anticonvulsants, such as Neurontin (gabapentin) and Tegretol (carbamazepine): These drugs are shown to relieve nerve pain in some people, but evidence for their use with neuromas is limited. They're considered an alternative for people who can't tolerate tricyclic antidepressants or an additional treatment for those who need more relief than tricyclics offer. Serotonin norepinephrine reuptake inhibitors (SNRIs), such as Cymbalta (duloxetine). SNRIs are commonly used to treat nerve pain and, like tricyclics, alter the way your brain processes pain signals. Corticosteroid injections, such as Medrol (methylprednisolone): These medications are powerful anti-inflammatories. They can help relieve nerve compression from inflamed tissues. Anti-inflammatory medications, such as NSAIDS (e.g., ibuprofen and naproxen sodium), are commonly used as well. Several physical therapy techniques can be used for neuromas, including: Desensitization exercises: This involves rubbing the residual limb with different textures to gradually decrease hypersensitivity. Electrical stimulation: This involves weak electrical current delivered to your muscles via electrodes. It can help alleviate muscle spasms, inflammation, and pain. Ultrasound: This provides deep heating to your soft tissues, which is thought to help them heal. This is a different procedure from ultrasound imaging, which is a diagnostic tool. Using ice to relieve swelling can also be effective. Surgery If other treatments fail, your healthcare provider may recommend surgery. Two types are common: Decompression, which is done by cutting nearby structures that put pressure on the nerveNerve removal, which can result in permanent numbness in the affected area Unfortunately, it's not uncommon for a new neuroma to form where the incision was made during nerve removal. All surgery comes with risks, so it's usually considered best to try conservative treatments first. If you are considering surgery, make sure to discuss all potential risks with your medical care team. Prevention Neuroma prevention depends on the specific type of neuroma and its cause. For Morton's neuroma, lifestyle changes may offer benefits. These options include: Resting and icing the area after activity, especially if it's sports-relatedWearing softer, wider shoes with plenty of room in the toes; avoiding tight, narrow shoesGetting shoe inserts that relieve pressure on the neuroma You also may want to adapt some activities that you don't realize are creating stress on your foot, such as bicycle riding. Even the hours you sit in an office chair may matter. One study of 100 people with Morton's neuroma found that office chair design may contribute to neuroma development. A Word From Verywell A neuroma can't be "cured" and, like all chronic pain, should be diagnosed and treated by a healthcare provider. However, treatment options including lifestyle changes, medication, and surgery are quite successful in treating many neuromas. 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Academy of Orthopaedic Surgeons. Morton's Neuroma. Yao C, Zhou X, Zhao B, Sun C, Poonit K, Yan H. Treatments of traumatic neuropathic pain: a systematic review. Oncotarget. 2017;8(34):57670–57679. doi:10.18632/oncotarget.16917 Sebastin SJ. Complex regional pain syndrome. Indian J Plast Surg. 2011;44(2):298–307. doi:10.4103/0970-0358.85351 American Podiatric Medical Association. What is a Neuroma? Harvard Medical School. Drugs that relieve nerve pain. Lizano-Díez X, Ginés-Cespedosa A, Alentorn-Geli E, et al. Corticosteroid Injection for the Treatment of Morton's Neuroma: A Prospective, Double-Blinded, Randomized, Placebo-Controlled Trial. Foot Ankle Int. 2017;38(9):944-951. doi:10.1177/1071100717709569 Del Mar Ruiz-Herrera M, Criado-Álvarez JJ, Suarez-Ortiz M, Konschake M, Moroni S, Marcos-Tejedor F. Study of the Anatomical Association between Morton's Neuroma and the Space Inferior to the Deep Transverse Metatarsal Ligament Using Ultrasound. Diagnostics (Basel). 2022 Jun 1;12(6):1367. doi:10.3390/diagnostics12061367. By Erica Jacques Erica Jacques, OT, is a board-certified occupational therapist at a level one trauma center. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit