If you’ve been to a podiatrist for foot problems, you may already have an idea of what Morton’s neuroma is. This condition usually affects the nerve between the third and fourth toes, which thickens and becomes extremely sensitive as bones and other tissues around it place pressure on it.
But what is a stump neuroma? Is it the same condition? Is it something different? Does it call for concern?
Let’s look at this little-known condition so you can understand the difference between these two neuromas and effectively treat your foot pain.
What Is Stump Neuroma?
Stump neuroma is a condition that may occur after trauma to the nerves in the ball of the foot. It often happens due to an unsuccessful surgery for Morton’s neuroma, but it can also occur after a traumatic injury involving severe lacerations to the foot.
If a stump neuroma occurs due to failed surgery to the nerve, a small nodule of nerve tissue forms on the end of a nerve that’s been cut.
This can cause similar symptoms to Morton’s neuroma, with extreme sensitivity and pain that can be made worse by the pressure of scar tissue on the nerve.
The same thing can happen to a nerve that’s been severed from a traumatic injury. In a nutshell, a stump neuroma is a traumatic nerve injury.
In some cases, the nerve can attempt to regrow but accidentally attach to other tissues, causing pressure and pain.
A stump neuroma usually develops within three to four months after surgery or injury. You may notice that a particular part of the ball of your foot becomes extremely sensitive and may be excruciatingly painful even with the lightest pressure placed on it.
The pain may be a burning or shooting pain. There may also be swelling, redness, and in some cases, a noticeable lump in the ball of the foot.
How Is It Different From Morton’s Neuroma?
Although the symptoms of stump neuroma are very similar to Morton’s neuroma, the biggest difference is the mechanism of injury.
Morton’s neuroma develops over time due to consistent pressure on the forefoot, either due to repeated high-impact activity or wearing shoes like high heels that place the forefoot under constant pressure.
Stump neuroma only occurs as a direct result of trauma—in most cases, a failed Morton’s neuroma surgery.
If you’ve never had a severe injury to the affected foot or undergone surgery, it’s likely to be Morton’s neuroma. But if you’ve had an injury or surgery, it’s highly likely to be stump neuroma.
How Do You Know If You Have Stump Neuroma?
A recent history of Morton’s neuroma surgery, along with severe pain in the ball of the foot close to where Morton’s neuroma was, is a sure sign of a stump neuroma.
If there is a recent history of severe foot injury rather than surgery, this could also be an indication of the condition.
The doctor will also take into account the timing of the pain. Stump neuroma pain usually only begins a few weeks to months after the initial surgery or injury.
If the pain is presenting too early after an injury or surgery, the doctor may consider other reasons for the pain, one of which may be a second undiagnosed neuroma in the foot.
If you have no history of foot injury or surgery, then the chances of having a stump neuroma is almost zero. In this case, it’s more likely to be Morton’s neuroma or metatarsalgia.
Tips for Dealing With Stump Neuroma
Most doctors will recommend conservative measures to treat stump neuromas. If these don’t work, then a repair surgery may be the best way forward. Try these measures before considering another surgery.
Change Your Shoes
Wearing shoes with a lower heel-to-toe drop can take pressure off the forefoot and somewhat alleviate your pain. A wide toe box will also allow your forefoot room to rest naturally without compressing the nerve.
Use An Orthotic
Often, those with pain in their foot—for whatever reason—inadvertently change their gait to try and accommodate the discomfort.
However, this can lead to other problems, such as ankle pain, knee pain, hip pain, or back pain, as the kinetic chain is out of alignment from the feet up.
If this is the case, you should invest in high-quality orthotic insoles. We advise getting your insoles made by a podiatrist who can create custom inserts for your feet that provide the right amount of support in the right places for your feet.
This can help to distribute your body weight more evenly, reducing pressure on the painful area of your foot and allowing you to still walk naturally.
Steroid Cream or Injections
Depending on the severity of the nerve thickening or entrapment, steroid creams may be able to help reduce pain and inflammation. This works best for nerves close below the skin.
For nerves deeper below the skin, steroid injections could help to reduce pain and ease inflammation. However, both of these measures are more likely to be temporary solutions, as too much exposure to steroids can be harmful.
Physiotherapy can be helpful in reducing pressure on the affected nerve. The physiotherapist may be able to manipulate the joints in the feet to alleviate pressure on the nerve, but it’s unlikely that this will be a permanent state.
This can be used in conjunction with other therapies, such as steroid creams, for the highest chance of relief from pain.
If conservative treatments don’t ease the pain and reduce the inflammation enough, as a last resort, you may need to go for another surgery to fix the affected nerve.
It’s a good idea to seek the advice of a different doctor rather than go back to the doctor who did your first surgery.
Depending on the severity of the damage to the nerve, there are multiple ways to treat it in surgery. Some doctors will choose cryosurgery or radiofrequency to desensitize the nerve.
Others may opt for nerve capping, which involves covering the severed nerve with a silicone cap to effectively separate it from other tissues and prevent it from reattaching. Success rates for this type of surgery are high.
Alternatively, transplanting a nerve into a vein or bone has also proven to be effective. However, your doctor will have to assess your case once the surgery has begun and make a decision.