A Joplin’s Neuroma or neuritis is an entrapment or pinching of what’s known as the inside plantar digital nerve. This specific nerve supplies sensation on the medial side and regions of the top and underside on the great toe or hallux. This particular entraped nerve was initially identified by Joplin in 1971 with 3 cases which came about soon after bunion surgery. The reason behind a Joplin’s Neuroma is most frequently as a result of continual compression about the big toe with recurring trauma to the nerve. This is mainly more likely to occur when using tight shoes, particularly if there is an underlying problem like a bunion in the big toe. This may also happen in some instances following a single occurrence of trauma instead of the repetitive trauma from shoes. Some other instances are due to an restriction with the nerve in scar tissue formation right after bunion surgical procedures.
The typical symptoms of a Joplin’s neuroma may differ from dull ache discomfort and some pins and needles to an acute shooting or radiating pain occurring around along the medial side of the great toe. The symptoms can generally be made more painful by the continued wearing of tight shoes. There could also be some numbness and tingling about the area. When you carefully palpate the area of the nerve, it’s sometimes easy to feel a lump over the area and the pressing on this mass can cause the symptoms which the person is having. There are many different problems which may imitate these types of features since the signs and symptoms of a Joplin’s neuroma may be somewhat hazy. You should get the medical diagnosis prior to carrying on with therapy. The differential diagnosis includes almost any other disorders which has an effect on the large toe joint. This may consist of osteo arthritis, rheumatoid arthritis or even gout. The signs and symptoms of these usually happen more inside the joint instead of radiating pains about the hallux joint. There might be swelling from a bunion with some bursitis that doesn’t involve the nerve getting entraped. A sesamoiditis may be considered, but this causes pain under the big toe or hallux joint and will not shoot forward. There also might be a traumatic damage to the hallux joint or even the structures surrounding the joint.
The first part of the treatment of a Joplin’s neuroma is to find some alleviation in the pain when it is bad enough. This may involve using ice and medications to ease the signs and symptoms. The key part of the treatment is using wider footwear or to modify the footwear to allow a lesser amount of force on the great toe or hallux joint. This may be problematic if tight fitting footwear needs to be used in sports such as soccer. Adhesive felt protective pads to get stress off the affected area could be very useful. This adhesive felt padding could be in the shape of a ‘U’ or even a donut. This really is required in order that there isn’t any pressure on the area the symptoms are coming from. A shot of corticosteroid is sometimes needed to settle the pain of the Joplins neuroma. When none of this helps, then a surgical removal of the affected nerve is usually necessary.