Morton's neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. Morton's neuroma may feel as if you are standing on a pebble in your shoe or on a fold in your sock. Morton's neuroma involves a thickening of the tissue around one of the nerves leading to your toes. This can cause a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb. High-heeled shoes have been linked to the development of Morton's neuroma. Many people experience relief by switching to lower heeled shoes with wider toe boxes. Sometimes corticosteroid injections or surgery may be necessary.
A Morton?s Neuroma are a result of complex biomechanical changes that occur in your feet. There are a number of theories as to the exact cause of the scarring and thickening, but it basically boils down to overload of the tissue structure. The body lays down scar tissue to try to protect the overloaded structure. Tight-fitting shoes may exacerbate a Morton?s Neuroma. Shoes such as high heels and shoes with tight toe boxes (eg womens fashion shoes and cowboy boots) are particularly damaging to the toes. These shoes have a sloping foot bed and a narrow toe box. The slope causes the front of the foot to bear your weight. The angle of the toe box then squeezes your toes together. Footwear is not the only cause of a Morton?s Neuroma. Injuries to the foot can also be a factor in developing the condition by changing your foot biomechanics. Poor foot arch control leading to flat feet or foot overpronation does make you biomechanically susceptible to a neuroma.
Morton's neuroma may cause Burning, pain, tingling, and numbness often shooting into the toes. Discomfort that is worse while walking. Feeling of a lump between the toes. Symptoms are usually temporarily relieved when taking off shoes, flexing toes or rubbing feet.
The diagnosis of interdigital neuroma is usually made by physical examination and review of the patient's medical history.MRI ad High Definition Ultrasound examination may be useful to confirm the diagnoses however they may still not be 100% reliable. The commonest reason for this is de to natural substances present in between the metatarsal heads and between the fat pad and the intermetatarsal ligament. These natural substances i.e. bursa, fat, capsular thickening and even bony growths, can all be a factor in the impingement process and may need to be surgically cleared.
Non Surgical Treatment
If your Morton's neuroma is painful, your doctor usually will begin treatment with conservative therapies, including a switch to shoes with low heels, wide toes and good arch support. Padding techniques, including metatarsal pads or toe crest pads. Shoe inserts (orthotics) to help correct any mechanical imbalance in the foot. Anti-inflammatory medication, such as ibuprofen (Advil, Motrin and other brand names) or naproxen (Aleve, Naprosyn and other brand names) A local injection of anesthetic and corticosteroid medication into the affected area. Inflamed or injured nerves can take months to improve, even after the underlying problem has been corrected.
Should the problem have progressed beyond the point where these measures are sufficient, the podiatric professional may recommend surgery. This procedure involves excision of the involved nerve mass. This will relieve the pain. Many patients report permanent numbness in the spot formerly affected by the neuroma, but prefer it to the pain. Most surgeries are successful; unfortunately, there are cases where the patient suffers another neuroma, sometimes in or near the same spot as before. A podiatric professional can explain the statistics of recurrence in various cases. If you suspect a neuroma, don?t wait for it to get better on its own. The earlier the diagnosis, the higher the likelihood that it can be treated with conservative measures. Don?t think that foot pain of any kind is inevitable, either, even if it runs in your family.