If these treatments are not effective, the enlarged area may need to be surgically removed. In one long-term study of one surgeon's experience, 85% of patients reported satisfaction as being good to excellent nearly six years after surgery. About 65% were pain free. Some numbness is common afterward but it rarely bothers patients. Occasionally, the nerve tissue may re-grow and form another neuroma.
Stress Fracture
A stress fracture in the foot, also called fatigue or march fracture, usually results from a break or rupture in any of the five metatarsal bones (mostly the second or third). These fractures are caused by overuse during strenuous exercise, particularly jogging and high-impact aerobics. Women are at higher risk than men are. A fracture in the first metatarsal bone, which leads to the big toe, is uncommon because of the thickness of this bone. If it occurs, however, it is more serious than a fracture in any of the other metatarsal bones because it dramatically changes the pattern of normal walking and weight bearing.
Treatment for Stress Fractures. Patients should seek treatment if pain persists for 3 weeks. In a study of young athletes, treatment after that time was associated with a lower chance for returning to their sport. Surgery may be needed if conservative measures fail. In most cases, however, stress fractures heal by themselves if rigorous activities are avoided. It is best to wear low-heeled shoes with stiff soles. Some physicians recommend moderate exercise, particularly swimming and walking. Occasionally, a physician may recommend wearing a special wooden shoe and a compressive wrap to make walking more comfortable.
Sesamoiditis
Sesamoiditis is an inflammation of the tendons around the small, round bones that are embedded in the head of the first metatarsal bone, which leads to the big toe. Sesamoid bones bear much stress under ordinary circumstances; excessive stress can strain the surrounding tendons. Often there is no clear-cut cause, but sesamoid injuries are common among people who participate in jarring, high-impact activities, such as ballet, jogging, and aerobic exercise.
Treatment for Sesamoiditis. Rest and reducing stress on the ball of the foot are the first lines of treatment for sesamoiditis. A low-heeled shoe with a stiff sole and soft padding inside is all that is usually required. In severe cases, surgery may be necessary.
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