Neuromas and peripheral neuropathies

Clinical Assessment

• Take a full medical history (including diabetes, medications, injury history).

• Assess symptoms such as burning, tingling, numbness, or sharp pain.

• Perform neurological testing (sensation testing with monofilament, vibration testing, reflex checks).

• Palpate and examine the foot to locate areas of nerve irritation (e.g., suspected Morton’s neuroma).

• Assess gait (walking pattern) and foot biomechanics.

• Evaluate footwear for fit and pressure points.
  
  

Diagnosis & Care Planning

• Identify likely neuroma or neuropathic involvement.

• Determine contributing factors (tight footwear, foot deformities, overuse, systemic conditions).

• Develop an individualized treatment plan

Pressure Reduction & Mechanical Management

• Provide padding, offloading devices, or strapping/taping.

• Recommend or prescribe custom orthotics to redistribute pressure.

• Advise on appropriate footwear (wide toe box, cushioning, low heel).

Symptom Management

• Provide soft tissue therapy or mobilization where appropriate.

• Recommend stretching or strengthening exercises.

• Suggest topical treatments or liaise with GP regarding pain management

• In some practices, administer corticosteroid injections (if within scope of practice).

Risk Management (Especially for Neuropathy)

• Conduct routine foot checks for skin breakdown or ulcers.

• Provide nail and skin care to prevent complications.

• Educate on daily foot inspection and injury prevention.

• Monitor circulation and refer if vascular concerns are identified.

Referral & Multidisciplinary Care

• Refer to GP, neurologist, or specialist if symptoms worsen or require imaging.

• Coordinate care for patients with diabetes or complex neuropathy.

In summary:

A chiropodist’s role is to assess nerve-related foot problems, reduce pressure on affected nerves, manage pain, prevent complications, and refer when necessary.