The first step in treating a neuroma, before even thinking about surgery, is to change one's shoes and/or insoles to give the foot more room. If that fails, the podiatrist examines the foot with an X-ray machine and ultrasound device to ensure the problem is only a neuroma.
If that's the case, the doctor injects cortisone into the affected area. The purpose of the cortisone injections is to fight inflammation and destroy tissue - the target tissue being the abnormal fibrous growth. Usually, the doctor administers a maximum of three cortisone injections, at least two weeks apart. If that approach doesn't work, the podiatrist turns to alcohol injections, which are designed to chemically dissolve the growth.
The procedure is also called sclerosing the nerve. Such injections help more than 75 percent of all patients avoid surgery. The other quarter of the patients must either learn to tolerate their pain or undergo surgery, which takes about a half-hour, with local anesthesia and a little sedation. Patients recover rather quickly, getting their sutures removed and returning to normal activities in about two weeks.
Generally speaking, neuromas that are less than 5 millimeters wide are cured by cortisone injections; those between 5 millimeters and 10 millimeters are cleared up by sclerosing, and those larger than 10 millimeters must be surgically removed.