Overview
Morton?s Neuroma is a common foot condition characterized by pain and swelling in the ball of the foot, between the third and fourth toes. It?s caused by bones in your feet squeezing a nerve. Symptoms include a sharp, burning pain and possibly separation between the affected toes.
Causes
There are many reasons to develop a neuroma. Improper shoe gear is probably the most likely cause. Repetitive activity and excessive pressure on the ball of the foot are common. Heredity and genetic factors may also be involved. In many cases the structure of the foot may predispose the condition. Associated conditions that may cause neuroma include: bunion, hammer toes, ligament laxity, and/or a tight calf muscle. Some patients may have thinning of the fat pad on the ball of the foot, which may result in increased pressure of the nerves. Tight pointy shoes (and high heels) without padding may induce pain in the ball of the foot. Neuroma may occur suddenly, or develop over time.
Symptoms
Symptoms associated with a neuroma include a dull burning sensation radiating towards the toes, a cramping feeling, or even a stinging, tingling sensation that can be described as being similar to an electric shock. It is often worse when wearing shoes with most people finding the pain disappears when removing their shoes.
Diagnosis
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
The first step in treating Morton’s Neuroma is to select proper footwear. Footwear with a high and wide toe box (toe area) is ideal for treating and relieving the pain. The next step in treatment is to use an orthotic designed with a metatarsal pad. This pad is located behind the ball-of-the-foot to unload pressure, and relieve the pain caused by the neuroma.
If problem persists, consult your foot doctor.
Surgical Treatment
If your pain continues despite several months of conservative treatment, your doctor may recommend surgery to remove the neuroma or to widen the space through which the affected nerve travels. These types of surgery often are done under local anesthesia. If your doctor removes a portion of the affected nerve along with the neuroma, you may develop permanent numbness between the toes.
