A condition that affects a plantar digital nerve that run between the bones in the ball of our feet. It commonly affects the nerve between the third and fourth metatarsal bones, causing pain and numbness in the smaller toes. Morton’s neuroma can develop in different areas of the ball of our feet and sometimes complicating its diagnosis.
What Causes Morton’s Neuroma?
The cause of Morton’s neuroma is not well understood. However, it’s believed to develop from chronic stress and irritation of a plantar digital nerve that runs between our metatarsals. There are several contributing factors to this stress. Some thickening (fibrosis) and swelling may then develop around the nerve. This can be classified as a neuroma and can lead to compression of the nerve.
The position of our bones also contributes to the development of Morton’s neuroma. The anatomical space is narrower between the second and third metatarsals, and between the third and fourth metatarsals. The nerves running between these areas can get compressed and irritated easily. Wearing narrow fitting shoes with higher heels can worsens this compression and enhances the stress.
How do I know if I have Morton’s neuroma?
People with Morton’s neuroma complain of a shooting pain in the ball of the foot that can make the small toes feel numb. Burning and tingling of the smaller toes can also occur. The pain may also feel as if your socks are bunched up under your toes.
Symptoms will be worse if you wear high-heeled and narrow fitting shoes. Pain is relieved by taking your shoe off, resting your foot and massaging the area. Symptoms can be intermittent in the beginning and worsen the longer the problem and pre-disposing factors are present. Caring for Morton’s neuroma earlier will prevent the pain from becoming more regular and persistent.
Morton’s Neuroma Diagnosis
Morton’s neuroma is usually diagnosed by your Chiropodist listening to your symptoms and examining your foot. Sometimes your Chiropodist can feel the ‘neuroma’, or an area of thickening in your foot, which may be tender.
Your Chiropodist may suggest getting an ultrasound or MRI scan to confirm the diagnosis but its not necessary in all cases. Some doctors inject a local anaesthetic into the area where you are experiencing pain. If this causes temporary relief of pain, burning and tingling, it can sometimes help to confirm the diagnosis and show the doctor where the problem is.
What can a Chiropodist do for you?
Simple treatments may be all that are needed for some people with a Morton’s neuroma.
- Footwear adjustments including avoidance of high-heeled and narrow shoes and having special orthotic pads and devices fitted into your shoes.
- Custom made foot orthotics to correct biomechanical faults and reduce pressure on the neuroma.
- Shockwave Therapy
- Calf-stretching exercises help relieve the pressure on the balls of your foot.
- Steroid or local anaesthetic injections into the affected area if symptoms persist.
- Alcohol sclerosing injections involve injecting alcohol mixed with local anaesthetic into the affected nerve.
If conservative measures fail, surgery might be your only solution. Surgery involves a small incision (cut) being made on either the top, or the sole, of the foot between the affected toes. If the nerve is resected (cut out), there can be permanent numbness of the skin between the affected toes. This does not usually cause any future problems. Surgery removal of Morton’s neuroma is generally successful. However, as with any surgical operation, there is a risk of complications.
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