Overview
Morton?s neuroma is a swollen nerve in the distal portion of the foot. The enlarged portion of the nerve represents scarring within the plantar nerve that occurs after chronic compression and/or repetitive injury. This may come about when the toes are squeezed together for too long, as can occur with the chronic use of high heels. The nerve that runs between your toes will swell and thicken. This can cause pain when walking. The symptoms of Morton?s neuroma can include burning pain in the foot, the feeling of a lump inside your foot, pain between the third and fourth toes typically but it can occur between other toes.
Causes
Anything that causes compression or irritation of the nerve can lead to the development of a neuroma. One of the most common offenders is wearing shoes that have a tapered toe box, or high-heeled shoes that cause the toes to be forced into the toe box. People with certain foot deformities - bunions, hammertoes, flatfeet, or more flexible feet - are at higher risk for developing a neuroma. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running or court sports. An injury or other type of trauma to the area may also lead to a neuroma.
Symptoms
Neuroma patients occasionally complain of a ?pins and needles? sensation that spreads through their feet, or of a feeling akin to hitting their ?funny bone.? The sensation may be described as similar to an electric shock. Some patients also say that these symptoms, as well as those listed above, will come and go, depending on what they are wearing on their feet, the activity they are doing, or on other external factors.
Diagnosis
The doctor will perform an examination of your feet as well. He or she may palpate your feet and flex them in specific ways that will indicate the presence of a neuroma. X-rays are often used to rule out other problems, such as fractures, bone spurs, arthritis or other problems with the bones in the toes or foot. In some cases, an MRI (magnetic resonance imaging) may be helpful to confirm the presence of a neuroma.
Non Surgical Treatment
Treatment strategies for Morton's neuroma range from conservative to surgical management. The conservative approach to treating Morton's neuroma may benefit from the involvement of a physical therapist. The physical therapist can assist the physician in decisions regarding the modification of footwear, which is the first treatment step. Recommend soft-soled shoes with a wide toe box and low heel (eg, an athletic shoe). High-heeled, narrow, nonpadded shoes should not be worn, because they aggravate the condition. The next step in conservative management is to alter alignment of the metatarsal heads. One recommended action is to elevate the metatarsal head medial and adjacent to the neuroma, thereby preventing compression and irritation of the digital nerve. A plantar pad is used most often for elevation. Have the patient insert a felt or gel pad into the shoe to achieve the desired elevation of the above metatarsal head. Other possible physical therapy treatment ideas for patients with Morton's neuroma include cryotherapy, ultrasonography, deep tissue massage, and stretching exercises. Ice is beneficial to decrease the associated inflammation. Phonophoresis also can be used, rather than just ultrasonography, to further decrease pain and inflammation.
Surgical Treatment
For those who are suffering severely with Morton?s Neuroma, surgery is a possibility. An orthopedic surgeon can remove the growth and repair your foot relatively easily. However, Morton?s Neuroma surgery is associated with a lengthy recovery time and there is a possibility that the neuroma may return.
Morton?s neuroma is a swollen nerve in the distal portion of the foot. The enlarged portion of the nerve represents scarring within the plantar nerve that occurs after chronic compression and/or repetitive injury. This may come about when the toes are squeezed together for too long, as can occur with the chronic use of high heels. The nerve that runs between your toes will swell and thicken. This can cause pain when walking. The symptoms of Morton?s neuroma can include burning pain in the foot, the feeling of a lump inside your foot, pain between the third and fourth toes typically but it can occur between other toes.
Causes
Anything that causes compression or irritation of the nerve can lead to the development of a neuroma. One of the most common offenders is wearing shoes that have a tapered toe box, or high-heeled shoes that cause the toes to be forced into the toe box. People with certain foot deformities - bunions, hammertoes, flatfeet, or more flexible feet - are at higher risk for developing a neuroma. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running or court sports. An injury or other type of trauma to the area may also lead to a neuroma.
Symptoms
Neuroma patients occasionally complain of a ?pins and needles? sensation that spreads through their feet, or of a feeling akin to hitting their ?funny bone.? The sensation may be described as similar to an electric shock. Some patients also say that these symptoms, as well as those listed above, will come and go, depending on what they are wearing on their feet, the activity they are doing, or on other external factors.
Diagnosis
The doctor will perform an examination of your feet as well. He or she may palpate your feet and flex them in specific ways that will indicate the presence of a neuroma. X-rays are often used to rule out other problems, such as fractures, bone spurs, arthritis or other problems with the bones in the toes or foot. In some cases, an MRI (magnetic resonance imaging) may be helpful to confirm the presence of a neuroma.
Non Surgical Treatment
Treatment strategies for Morton's neuroma range from conservative to surgical management. The conservative approach to treating Morton's neuroma may benefit from the involvement of a physical therapist. The physical therapist can assist the physician in decisions regarding the modification of footwear, which is the first treatment step. Recommend soft-soled shoes with a wide toe box and low heel (eg, an athletic shoe). High-heeled, narrow, nonpadded shoes should not be worn, because they aggravate the condition. The next step in conservative management is to alter alignment of the metatarsal heads. One recommended action is to elevate the metatarsal head medial and adjacent to the neuroma, thereby preventing compression and irritation of the digital nerve. A plantar pad is used most often for elevation. Have the patient insert a felt or gel pad into the shoe to achieve the desired elevation of the above metatarsal head. Other possible physical therapy treatment ideas for patients with Morton's neuroma include cryotherapy, ultrasonography, deep tissue massage, and stretching exercises. Ice is beneficial to decrease the associated inflammation. Phonophoresis also can be used, rather than just ultrasonography, to further decrease pain and inflammation.
Surgical Treatment
For those who are suffering severely with Morton?s Neuroma, surgery is a possibility. An orthopedic surgeon can remove the growth and repair your foot relatively easily. However, Morton?s Neuroma surgery is associated with a lengthy recovery time and there is a possibility that the neuroma may return.