Mortons Neuroma is often termed an "inter-digital" neuroma because it is found between the toes of the foot, most commonly the 3rd and 4th toes. It can also occur between the metatarsal bones (the long bones in the forefoot).
It is basically an entrapped nerve which becomes inflamed due to constant irritation from the surrounding bony structures. If this trauma persists, soft tissue adaptation will result in the thickening of the nerve.
Symptoms associated with this type of foot neuroma include a dull burning sensation radiating towards the toes, or even a stinging sensation that can be described as being similar to an electric shock.
Other symptoms of foot neuroma may include a numb toe or multiple toe numbness. Pain under the ball of the foot is also often experienced.
Constant trauma from the surrounding bones (metatarsals) can damage the nerve branches and therefore the body will try and protect the nerve by increasing the thickness of the nerves insulating sheath. This constant abuse to the nerve branch is present when the foot is unstable.
This means that there is an imbalance in the structure of the foot causing abnormal motion. This abnormal motion causes forefoot instability and is one of the primary factors associated with the formation of a foot neuroma.
A neuroma should always be treated conservatively initially. First, this means trying to remove the causative factors. Your Podiatrist will outline a treatment programme for you which consists of two or more of the following steps.
1. ASSESS TIGHT FITTING FOOTWEAR.
Tight footwear causes a pressure on the bones of the forefoot, increasing the irritation on the nerve.
2. ADDRESS THE FOOT AND LOWER LIMB BIOMECHANICS.
This involves diagnosing the cause of the foot instability and prescribing a customized shoe insert called an orthotic appliance to correct abnormal foot function.
Foot orthoticsand correctly fitted footwear often resolves the complaint of Mortons Neuroma. Orthoses with special modifications using metatarsal domes and footwear with a wider fit in the forefoot will often eliminate painful symptoms.
3. ANAESTHETIC/CORTISONE INJECTIONS.
This is done when the above treatments are insufficient. The trauma is sometimes so great that conservative treatment cannot control the inflammation. A series of injections are performed to control the inflammation. Appropriate referral is arranged if this treatment is necessary.
4. MORTONS NEUROMA SURGERY.
This is the last and most permanent course of action. Neuroma surgery is considered only after conservative forms of treatment have failed to provide sufficient relief of symptoms.
An incision is made in the top of the foot and the entrapped nerve is excised. Obviously the results are permanent, but not without some side affects. Your Podiatrist can discuss this course of treatment with you should it be required.
So remember! A neuroma is a nerve that is being traumatized by a poorly functioning foot and treating the cause of this condition is paramount.
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WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist, your Doctor or your foot specialist.
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