Chronic Pain Types An Overview of Neuroma Abnormal growths that can cause pain By Erica Jacques linkedin Erica Jacques, OT, is a board-certified occupational therapist at a level one trauma center. Learn about our editorial process Erica Jacques Medically reviewed by Medically reviewed by Grant Hughes, MD on March 07, 2020 linkedin Grant Hughes, MD, is board-certified in rheumatology and is the head of rheumatology at Seattle's Harborview Medical Center. Learn about our Medical Review Board Grant Hughes, MD on March 07, 2020 Print Table of Contents View All Symptoms Causes Diagnosis Treatments 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." A common type called Morton's neuroma grows between the third and fourth toes. Another common site is the back of the hand. However, neuromas can occur anywhere in the body. Caiaimage / Robert Daly / Getty Images Symptoms 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 abnormal pain types, categorized as dysesthesias. Dysesthesia is defined as abnormal sensation. These can be painful or just unpleasant (although that distinction can be hard to make.) Neuromas are associated with two types of dysesthesias that do cause often significant pain. They are: 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: 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. Abnormal Pain Type: Allodynia Specific symptoms depend on the region of the body where the neuroma forms. In Morton's neuroma, which is most often between the third and fourth toes, 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 An Overview of Morton's Neuroma 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. 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. An Overview of CRPS 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 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 repairTight shoesHigh heels with pointed toesFlat 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 doctor 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 is sometimes used, but it can lead to false positives and is much more expensive than an ultrasound. Doctors 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. 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. 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. You can also try some lifestyle changes, such as: Resting and icing the area after activity.For Morton's neuroma, wearing shoes with plenty of room in the toes and getting shoe inserts that relieve pressure on the neuroma. An Overview of Morton's Neuroma Surgery If other treatments fail, your doctor 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 A common problem with nerve removal is that a new neuroma may form where the incision was made. 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. A Word From Verywell The pain from neuromas can be debilitating and, like all chronic pain, can wear you down mentally and emotionally. The good news is that you have a lot of treatment options to consider. Work with your doctor to figure out the right treatments for you. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article 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. Updated September 2012. 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 Stokvis A, Coert JH. Operative treatment of painful neuromas. Ned Tijdschr Geneeskd. 2011;155(18):A2592. 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. Updated November 14, 2018. 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