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What Is Mortons Neuroma
03.06.2017 02:39
Overview

plantar neuromaA Morton?s Neuroma is actually incorrectly termed, with the name suggesting it is a tumour or growth. Rather than a true neuroma it is actually what is called a perineural fibrosis, which means that over time the sheath surrounding the nerve becomes irritated, inflamed, and forms a thickened scar tissue.

Causes

Wearing shoes that are too tight can make the pain of Morton's neuroma worse. This is because the toe bones are more likely to press on the affected nerve if your shoes are too tight. High-heeled shoes, particularly those over 5cm (2 inches), or shoes with a pointed or tight toe area, can also compress your toes and make the pain worse. This is why women tend to be affected by Morton's neuroma more than men.

Foot conditions.

Symptoms

Morton?s neuroma is a progressive condition which means the symptoms typically get worse over time. Initially people often complain of a tingling or numbness at the base of their toes, typically in the space between the third and fourth toes, or, less commonly , between the second and third toes, which feels a bit like pins and needles. Over time the pain progresses and can feel like a stabbing or burning sensation in the ball of the foot under the toes. Some describe it as feeling as if they are standing on a stone. Normally the pain will get worse when you wear tight fitting shoes. Doing exercise that impacts on the foot such as jogging can also make the symptoms worse. The extent of the pain varies from person to person but in some cases it can be so intense that every step can feel acutely painful.

Diagnosis

Patients with classic Morton?s neuroma symptoms will have pain with pressure at the base of the involved toes (either between the 2nd and 3rd toes, or between the 3rd and 4th toes). In addition, squeezing the front of the foot together can exacerbate symptoms. As well, they may have numbness on the sides of one toe and the adjacent toe, as this corresponds with the distribution of the involved nerve.

Non Surgical Treatment

Treatment for Morton?s Neuroma usually begins conservatively, with a change in lifestyle choices. People suffering from the condition may find pain relief by reducing activity levels, changing footwear, using orthopedic supports, reducing weight. Medications are also available to help relieve the pain of Morton?s Neuroma. Over-the-counter medications are sometimes very helpful in reducing pain and inflammation. Your health care provider can also provide you with anesthetic or corticosteroid injections. These help to numb the area affected by the neuroma, and reduce inflammation.plantar neuroma

Surgical Treatment

Operative treatment of Morton?s neuroma should be entertained only after failure of non-operative management. Standard operative treatment involves identifying the nerve and cutting (resecting) it proximal to the point where it is irritated/injured. This is usually done through an incision on the top (dorsal) aspect of the foot, although an incision on the sole (plantar) aspect of the foot can be used. Some physicians will attempt to treat Morton?s neuroma by releasing the intermetatarsal ligament, and freeing the nerve of local scar tissue. This may also be beneficial.

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