When a nerve is cut, the piece of nerve that is beyond the cut point eventually
dies, however, its Schwann cells, the cells that encircle the nerve fibers remain
for a much longer time. These Schwann cells secrete a chemical messenger
known as nerve growth factor that tells the cut end of nerve where to grow back.
So the cut end of nerve will send out multiple sprouts in the direction of the
nerve growth factor, however, these sprouts do not go out in an orderly manner,
instead they grow out in all directions and eventually cluster and form a knot of
nerve fibers. This eventually leads to the formation of a TRUE neuroma or a
END BULB or STUMP neuroma. If it is in a place on your foot where you put a
lot of pressure, it will become very painful.
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To treat a painful, TRUE neuroma, the enlarged bulb and or sprouts are resected and
implanted into the deep muscles forefoot or of the arch where the nerve feels more
"at home". This takes the nerve out of a weight bearing region, into a quieter
region where it will not be subject to weight or compression.
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