Morton?s neuroma is a swollen nerve in the distal portion of the foot. The enlarged portion of the nerve represents scarring within the plantar nerve that occurs after chronic compression and/or repetitive injury. This may come about when the toes are squeezed together for too long, as can occur with the chronic use of high heels. The nerve that runs between your toes will swell and thicken. This can cause pain when walking. The symptoms of Morton?s neuroma can include burning pain in the foot, the feeling of a lump inside your foot, pain between the third and fourth toes typically but it can occur between other toes.
Although the exact cause for this condition is unclear, a number of factors can contribute to the formation of a neuroma. Biomechanical deformities, such as a high-arched foot or a flat foot, can lead to the formation of a neuroma. These foot types bring on instability around the toe joints, leading to the development of the condition. Trauma can cause damage to the nerve, resulting in inflammation or swelling of the nerve. Improper footwear that causes the toes to be squeezed together is problematic. Avoid high-heeled shoes higher than two inches. Shoes at this height can increase pressure on the forefoot area. Repeated stress, common to many occupations, can create or aggravate a neuroma.
Neuroma patients occasionally complain of a ?pins and needles? sensation that spreads through their feet, or of a feeling akin to hitting their ?funny bone.? The sensation may be described as similar to an electric shock. Some patients also say that these symptoms, as well as those listed above, will come and go, depending on what they are wearing on their feet, the activity they are doing, or on other external factors.
The diagnosis of a Morton’s neuroma can usually be made by the doctor when the history of pain suggests it and the examination elicits the symptoms. The foot is generally tender when the involved area is compressed and symptoms of pain and sometimes tingling can be elicited when the sides of the foot are squeezed. Magnetic resonance imaging (MRI) or ultrasound testing can be used to confirm the diagnosis if necessary.
Non Surgical Treatment
Relief of symptoms can often start by having a good pair of well fitting shoes fitted to your feet ensuring that the shoes don’t squeeze your foot together. Once footwear is addressed patients may require a small pre-metatarsal pad to be positioned onto the insole of the shoe to help lift and separate the bones in the forefoot to alleviate the pressure on the nerve. If the patients foot structure and mechanics is found to be a contributing cause, a custom made orthotic is usually the most convenient and effective way to manage the problem. Sometimes an injection of local anaesthetic and steroid is recommended to assist in settling acute symptoms.
Surgery may be considered in patients who have not responded adequately to non-surgical treatments. Your foot and ankle surgeon will determine the approach that is best for your condition. The length of the recovery period will vary, depending on the procedure performed. Regardless of whether you?ve undergone surgical or nonsurgical treatment, your surgeon will recommend long-term measures to help keep your symptoms from returning. These include appropriate footwear and modification of activities to reduce the repetitive pressure on the foot.
It is not always possible to prevent a Morton’s neuroma. However, you probably can reduce your risk by wearing comfortable shoes that have low heels, plenty of toe space and good arch support.