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Morton’s Neuroma

Morton’s Neuroma is a painful condition that affects mainly between the third and fourth toes. It is the thickening of the tissue around the nerve that runs in the gap between those two toes. The nerves can also become bunched togetherand this is called a neuroma.

Symptoms

There isn’t an outward appearance; however, these sensations are felt;

  • Pains in the ball of the feet, especially between the third and fourth metatarsal heads leading to the toes.
  • Burning/tingling/numbness in the toes
  • Feeling of a stone, or bunched socks in your shoes.

Causes

What causes Morton’s Neuroma? It is still a dilemma for most doctors. A precise cause for this condition hasn’t yet been found. Pressure on the feet, irritation or an injury, are the common things that tend to lead to the nerves being damaged. The thickening of the neuroma (nerve tissue) comes out of the body’s natural responses to abnormal activities such as injuries or some type of irritation.

Risk Factors

From research done, though not totally conclusive, the following are suspected to give rise to the problem:

  • Persons with hammertoes, bunions, flat feet or any other such deformity, are high risk in developing the condition.

  • Wearing high heeled/hard/ill fitting shoes where pressure is placed on the ball of the feet because of lack of toe box area, especially in the case of pointy tipped shoes.

  • High impact sporting activities which can cause repeated trauma to the feet and body as a whole.

Testing and Diagnosis

Many pains are similar in nature; and those associated with Morton’s Neuroma are similar to those of metatarsalgia and arthritis, to list a few. The best ways to attempt to determine whether the condition exists is to do an X-ray, and in some cases MRI testing. The X-ray would detect any abnormalities, whereas the MRI does the same but also picks up if any compression is taking place, and the size of the neuroma. The MRI scan helps as well in determining whether or not surgery is required, and if needed, the amount of nerve that should be removed and the exact position. These findings would help decide the type of surgical procedure to be executed.

Treatments

There are different treatment options to suit the severity of the problem.

  • Metatarsal cushions to pad the ball of the foot area.

  • Arch Supports (Orthotics) to serve as shock absorbers for the feet, taking the pressure off the nerve.

  • Proper footwear to ensure that minimal pressure is placed on the feet

  • Corticosteroid (steroid) injections sometimes help with pain, but they are NOT recommended to be done on a regular basis.

  • Cryogenic neuroablation, a minimally invasive procedure, which exposes the nerve to very cold temperatures. What it does is interfere with the transmission of pain signals.

Surgery

 Although surgery is usually successful, doctors often turn to surgery as a last resort. In some instances surgery is the only option. Here are three types:

 Decompression – with this method relief can be had by taking the pressure off the nerve via cutting nearby structures, such as the ligament that binds together some of the bones in the front of the foot.

Dorsal Approach – where the incision is made at the top of the foot and the down time is very little. It has been said that this kind of surgery is not always beneficial in the long run as it may lead to instability in the forefoot.

Plantar Approach – the incision is made on the sole of the foot and has the patient down for some weeks, moving around with a walking aid. This method is often preferred by doctors since it is easier to access the neuroma.

But surgery is not without complications. The area that undergoes surgery contains a large number of nerves, small blood vessels and muscles as well. This is why there is a huge chance for complications to occur in these cases.

 Secondly, there is a chance for recurrence that might require further treatment or surgery. The procedure removes both the neuroma and the nerve so it can leave permanent numbness in the affected toes.

Your specialist would help with the treatment that needs to be taken. The length of recovery time required could vary greatly depending upon the type of surgery undertaken, and the procedures performed.

Home and Lifestyle Remedies

For relieving the relief of pain and to allow the nerve to heal, consider the following:

  • Anti-inflammatory medications – Try the over-the-counter nonsteroidal anti-inflammatory medications, such as aspirin and ibuprofen.

  • Ice massage. – Regular ice massage may help. Freeze a water-filled paper cup or plastic foam cup and roll it over the painful site.

  • Change in footwear – As usual, avoid high heels or tight shoes. Choose those with extra depth and a broad toe box.

  • Reduction in activities. For a few weeks, cut down on high impact activities like dancing, aerobic exercise or jogging.

In extreme cases where the above treatments show no results, you may be advised to undergo surgery. Consult your doctor about the pros and cons of each one of these treatments and then select the one that suits you best.

Your feet mirror your general health . . . cherish them!

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