Put simply – Morton’s neuroma is a swollen (inflamed) nerve in the ball of the foot, commonly between the base of the second and third toes. Patients experience numbness and pain in the affected area, which is relieved by removing footwear and/or massaging the foot. A neuroma is a tumor that arises in nerve cells, a benign growth of nerve tissue that can develop in various parts of the body. In Morton’s neuroma the tissue around one of the nerves leading to the toes thickens, causing a sharp, burning pain in the ball of the foot. A sharp severe pain, often described as a red hot needle may come on suddenly while walking. There may also be numbness, burning and stinging in the toes. Although it is labeled a neuroma, many say it is not a true tumor, but rather a perineural fibroma (fibrous tissue formation around nerve tissue).
Inappropriate footwear is one of the principle causes of Morton?s neuroma. Toe spring and tapering toe boxes are the most problematic shoe design features that contribute to this health problem. Morton?s neuroma occurs when one of your nerves is stretched and pinched, which happens with great frequency in people who wear shoes incorporating these design features. A professional shoe fitting should always be sought if you are struggling with neuroma-related symptoms.
Pain is usually increased by forefoot weight bearing activities (such as running), with narrow-fitting footwear, or with high heeled shoes. It is usually painful to firmly touch the affected region and, in chronic cases, pain and sometimes an audible click, may be heard when squeezing the foot and toes together with the hand. Often a localized area of swelling may be evident at the site of injury.
A GP (general practitioner, primary care physician) or a podiatrist (foot specialist doctor) will ask the patient to describe the pain as well as its intensity, when symptoms started, what types of shoes are worn, as well as some questions about their job, lifestyle and hobbies. The doctor will then examine the foot and try to locate the affected nerve. This may involve attempting to reproduce symptoms by manipulating the foot. In order to get a detailed image of the inside of the food, one of the following scans may be ordered. X-ray, this is a type of high-energy radiation. In low doses they are used to diagnose diseases and condition by making pictures of the inside of the body. In higher doses they are used to treat cancer. This procedure is non-invasive and painless. Ultrasound scan, high frequency sound waves are pointed at a specific part of the body, which in this case is the foot. The ultrasound waves bounce of tissues; their echoes are then converted into a picture, called a sonogram. This allows the doctor to get an inside view of the foot. This procedure is non-invasive and painless. MRI (magnetic resonance imagining) a device that uses a magnetic field and radio waves to create detailed images of the body. Unlike CT scanning or general x-ray studies, no ionizing radiation is involved with an MRI. This procedure is non-invasive and painless. The doctor will have to rule out other conditions which may have similar symptoms, including capsulitis, bursitis, or Freiberg’s disease.
Non Surgical Treatment
Treatment options vary with the severity of each neuroma, and identifying the neuroma early in its development is important to avoid surgical correction. For simple, undeveloped neuromas, a pair of thick-soled shoes with a wide toe box is often adequate treatment to relieve symptoms, allowing the condition to diminish on its own. For more severe conditions, however, additional treatment or surgery may be necessary to remove the tumor. The primary goal of most early treatment regimens is to relieve pressure on areas where a neuroma develops. Your podiatric physician will examine and likely X-ray the affected area and suggest a treatment plan that best suits your individual case. Padding and Taping. Special padding at the ball of the foot may change the abnormal foot function and relieve the symptoms caused by the neuroma. Medication. Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the neuroma. Orthotics. Custom shoe inserts made by your podiatrist may be useful in controlling foot function. Orthotics may reduce symptoms and prevent the worsening of the condition.
Surgery to remove the neuroma may be recommended if more conservative treatment does not solve the problem. While surgery usually relieves or completely removes the symptoms, it often leaves a permanent numb feeling at the site of the neuroma.
Always warm-up thoroughly before vigorous athletics. Avoid activities that cause pain. Stretch and strengthen the feet through gradual exercise.