A neuroma is a growth or tumor that arises from nerve tissue. It can occur at the end of an injured nerve fiber and is usually not malignant. Neuromas occur most frequently in the foot and ear. The most common neuroma in the foot is a Morton's neuroma and an acoustic neuroma occurs in the ear. Patients experience pain or numbness in the area that is innervated by the nerve. A neuroma in the foot will cause pain in the ball of the foot, numbness between the toes, clicking sensation when walking or pain after jogging. Patients who suffer from an acoustic neuroma experience a gradual hearing loss, ringing in the affected ear, dizziness and facial numbness or weakness. There are similarities in treatment for both locations.
Monitoring
According to MayoClinic.com, physicians may recommend monitoring the growth and progression of an acoustic neuroma because they usually grow very slowly. Regular imaging and hearing tests may be recommended in older adults who are otherwise not a good candidate for surgery. Morton's neuroma necessitates treatment in order to reduce pain and allow for ambulation, according to Dr. Robert Parker, board-certified Podiatric Surgeon.
Rest and Ice
According to Cleveland Clinic, individuals who suffer from a Morton's neuroma may also include rest and ice of the area into their treatment protocol in order to reduce pain and inflammation. Ice applied shortly after activity helps to reduce the inflammation in the foot and the increasing pressure over at the nerve tumor.
Anti-Inflammatory Medications
Anti-inflammatory medications will help to relieve the pain of both a Morton's neuroma and an acoustic neuroma. Individuals suffering from pain and numbness in the foot from a Morton's neuroma may experience relief from cortisone injections into the area, according to Dr. Robert Parker.
Orthotics
Orthotics are special shoe insert that are custom fit to the foot of the individual. According to Dr. Robert Parker, orthotics will address the abnormal movement of the bones in the foot in order to reduce the amount of friction and trauma that occurs to the nerve root with a Morton's neuroma. In some cases, the patient will find that a combination of cortisone injections and orthotics offer the best possible relief.
Chemical Destruction
According to PodiatryNetwork.com and Dr. Kirk Koepsel, chemical destruction using injections of alcohol directly into the area may help destroy the tumor and relieve the pain in individuals who suffer from a Morton's neuroma. This treatment requires seven injections over a period of time and currently has a success rate of between 40 and 60 percent.
Surgical Removal
The goal of surgery in patients who have a Morton's neuroma or an acoustic neuroma is to remove the tumor and preserve as much nerve function as possible. According to MayoClinic.com, physicians attempt to prevent facial paralysis and preserve hearing in individuals who suffer from an acoustic neuroma. Surgical removal occurs under general anesthesia and access to the area is through an incision in the skull. Patients may require six days of inpatient hospitalization to start the recovery period. Individuals with a Morton's neuroma may risk infection, toe stiffness or a recurrent neuroma with surgical removal, according to Cleveland Clinic.
Stereotactic Radiosurgery
According to MayoClinic.com, stereotactic radiosurgery involves the use of the gamma knife radio surgical procedure that allows physicians to deliver radiation to the acoustic neuroma without making an incision. Physicians use imaging scans to pinpoint the area in the procedure, which is completed under local anesthetic. The purpose is to stop the growth of the tumor. The process can also be used to treat residual tumors left after open surgical removal, in areas of the brain that the surgeon may not be able to reach without causing damage to brain tissue.
