Neuromas are best described as benign tumors of the common plantar digital nerves. Patients will describe varied symptoms such as burning, shooting pain, a tingling electrical feeling and a prominent mass. All of these affect the bottom of the forefoot and the second and third or third and fourth digits.
In the past, 80 percent of neuromas required surgical resection to resolve the symptom and 20 percent responded, temporarily, to a steroidal injection.
Surgical resection is still a widely accepted method of primary intervention for the treatment of neuroma.
Over the past 10 years, some physicians have begun using a chemical destructive technique that we call a neurolytic series of injections. Dr. McNamara believes that surgery should be performed only after failure of the neurolytic injection series.
There are five injections in the series, one given every two weeks. The effectiveness is not known until one month after the last injection has been given. Dr. McNamara finds that with ultrasound guidance, his success rate in achieving 100 percent resolution of symptoms occurs in 85 to 90 percent of cases.