Morton’s Neuroma

Description

Morton's Neuroma is a painful condition of the foot referring to a pinched nerve or benign nerve tumor. The pain, typically between the third and fourth toes, presents as a combination of pain, burning and numbness between the toes and under the sole of the foot.

The main complaint associated with neuroma is pain between the toes when walking. Sufferers find relief by stopping their walk, removing their shoe, and rubbing the affected area.

Sometimes, patients describe the associated sensation like having a rock in their shoe. Morton's neuroma can occur in adults of all age groups, although it occurs more often in women than in men.

It usually affects one foot, but both can be affected. It most often occurs between the 3rd and 4th metatarsals under the sole of the foot.

Symptoms of Morton's Neuroma

• Pain in the forefoot and between the toes (usually 3rd and 4th).
• Numbness under sole of foot and toes.
• Swelling between toes.
• Intensifying pain under the sole of the foot, particularly with weight-bearing.

When is surgery indicated?

When conservative therapy has failed to provide adequate symptomatic relief or conservative treatment options are impractical.

Find out more about neuroma surgery

How can I tell if I have Morton's neuroma?

A clinical examination by your podiatrist can diagnose it, as you can usually feel a clicking sound between the toes.

Ultrasound and magnetic resonance imaging can also be used to visualize the neuroma and surrounding structures.

Diagnostic injection of a local anesthetic helps localize the neuroma.

X-rays can be used to rule out any other form of pathology.

Why does neuroma develop?

Although the exact cause of this condition is unclear, several factors may contribute to neuroma formation:

• The position of the bones on either side of the nerve causes a narrowing of this area, leading to nerve inflammation and irreversible thickening of the nerve.
• Biomechanical deformities, such as a high arch or flat foot, can lead to neuroma formation, as these types of feet cause instability around the foot joints.
• Trauma and inappropriate footwear can also cause damage, such as inflammation or swelling of the nerve.
• Repeated stress, common to many professions and sporting activities, can also impair nerve circulation.

How to relieve symptoms?

• Wear shoes that are wide, leave enough room for the toes, and have laces for a comfortable fit, not too tight and with a small heel.
• Wear shoes with a rigid, shock-absorbing heel and sole, to help relieve excessive pressure on the feet.
• Avoid high-heeled shoes, which increase pressure on the forefoot and contribute to many foot problems.
• Rest the foot and massage the affected area to temporarily reduce pain.
• Ice is also recommended.

Neuroma treatment

Treatment options vary according to severity:

• Custom-made foot orthoses to control abnormal foot function.
• Specific cushioning under the sole of the foot to reduce pressure.
• Anti-inflammatory medication.
• Injections can be used to reduce nerve inflammation.
• Surgery (see Neuroma surgery).

What happens if a neuroma is not treated quickly?

• Irreversible growth of the neuroma.
• Increased discomfort in the affected area.
• Inability to wear certain shoes.
• Inability to perform certain tasks.
• Obligation to remove the neuroma (see Neuroma surgery).