What Is a
Neuroma?
Morton's
Neuroma is a common foot
problem associated with
pain, swelling and/or an
inflammation of a nerve,
usually at the
ball-of-the-foot between the
3rd and 4th toes. Symptoms
of this condition include
sharp pain, tingling,
burning, or numbness, a
feeling that something is
inside the ball of the foot,
and even a lack of feeling
in the affected area.
Morton's Neuroma may also
cause numbness, tingling, or
cramping in the forefoot.
The progression
of a Morton’s neuroma often follows this
pattern:
- The
symptoms begin gradually. At first
they occur only occasionally, when
wearing narrow-toed shoes or
performing certain aggravating
activities.
- The
symptoms may go away temporarily by
removing the shoe, massaging the
foot, or by avoiding aggravating
shoes or activities.
- Over time
the symptoms progressively worsen
and may persist for several days or
weeks.
- The
symptoms become more intense as the
neuroma enlarges and the temporary
changes in the nerve become
permanent.
Causes
Morton's Neuroma is a
foot condition caused from
an abnormal function of the
foot that leads to bones
squeezing a nerve usually
between the 3rd and 4th
metatarsal heads. This
condition can be caused by
footwear selection. Footwear
with pointed toes and/or
high heels can often lead to
a neuroma. Constricting
shoes can pinch the nerve
between the toes, causing
discomfort and extreme pain.
Diagnosis
To arrive at a diagnosis, the foot
and ankle surgeon will obtain a thorough
history of your symptoms and examine
your foot. During the physical
examination, the doctor attempts to
reproduce your symptoms by manipulating
your foot. Other tests or imaging
studies may be performed.
The best time
to see your foot and ankle surgeon is
early in the development of symptoms.
Early diagnosis of a Morton’s neuroma
greatly lessens the need for more
invasive treatments and may avoid
surgery.
Non-surgical
Treatment
In developing a treatment plan, your
foot and ankle surgeon will first
determine how long you’ve had the
neuroma and evaluate its stage of
development. Treatment approaches vary
according to the severity of the
problem.
For mild to
moderate neuromas, treatment options may
include:
-
Padding. Padding techniques
provide support for the metatarsal
arch, thereby lessening the pressure
on the nerve and decreasing the
compression when walking.
-
Icing. Placing an icepack on
the affected area helps reduce
swelling.
-
Orthotic devices. Custom
orthotic devices provided by your
foot and ankle surgeon provide the
support needed to reduce pressure
and compression on the nerve.
-
Activity modifications.
Activities that put repetitive
pressure on the neuroma should be
avoided until the condition
improves.
- Shoe
modifications. Wear shoes
with a wide toe box and avoid
narrow-toed shoes or shoes with high
heels.
-
Medications. Oral
nonsteroidal anti-inflammatory drugs
(NSAIDs), such as ibuprofen, may be
recommended to reduce pain and
inflammation.
-
Injection therapy. Treatment
may include injections of cortisone,
local anesthetics or other agents.
When Is
Surgery Needed?
Surgery may be considered in
patients who have not responded
adequately to non-surgical treatments.
Your foot and ankle surgeon will
determine the approach that is best for
your condition. The length of the
recovery period will vary, depending on
the procedure performed.
Regardless of
whether you’ve undergone surgical or
nonsurgical treatment, your surgeon will
recommend long-term measures to help
keep your symptoms from returning. These
include appropriate footwear and
modification of activities to reduce the
repetitive pressure on the foot
