Morton?s neuroma is inflammation, thickening, or enlargement of the nerve between the bones of the toes (metatarsal bones). The condition is also called intermetatarsal neuroma. The thickening is usually found between bones of the third and fourth toes of the foot, but sometimes it may develop between the second and third toes. It occurs when the medial plantar nerve near the bones of those toes becomes compressed or irritated, possibly because the metatarsal bones press against the nerve in the narrow gap between the toes. If left untreated, Morton?s neuroma can cause a sharp, burning, or shooting pain that often gets worse over time. The pain becomes worse when a person walks or stands on the ball of the foot. Sometimes the pain reaches the toes next to the neuroma and a sensation of tingling or numbness is felt.
When a nerve is pinched between bones, the result is swelling of the nerve. It is this swelling which is referred to as a Neuroma. When the condition occurs in the foot, it is known as a Morton?s Neuroma. Morton?s Neuroma is technically not a tumor. Rather, it is a thickening of the tissue that surrounds the digital nerves leading to the toes. These nerves allow for physical sensation on the skin of the toes. The region of inflammation is found where the digital nerve passes under the ligament connecting the toe bones (metatarsals) in the forefoot. Morton?s Neuroma commonly develops between the third and fourth toes, generally as a result of ongoing irritation, trauma or excessive pressure. In some cases, the second and third toes are involved. Morton?s Neuroma is confined to one foot in most cases, though it can occur in both, particularly in athletes such as runners.
What are the symptoms of Morton?s neuroma? A sharp or stinging pain between the toes when standing or walking. Pain in the forefoot between the toes. Swelling between the toes. Tingling (?pins and needles?) and numbness. Feeling like there is a ?bunched up sock? or a pebble or marble under the ball of the foot.
Your doctor will suspect that you have a Morton's neuroma based on the nature and location of your foot pain. He or she may ask questions about your shoes - what type of shoes you usually wear and whether these shoes have narrow toes or high heels. To rule out other causes of foot pain, your doctor may ask questions about your medical history, especially any history of arthritis, nerve and muscle problems or previous injury to your foot or leg.
Non Surgical Treatment
Treatments may include rehabilitation measures to reduce nerve Irritation. Switching to low-heeled, wide-toed shoes with good arch support. Wearing padding in the shoes and/or between the toes. Wearing shoe inserts to correct a mechanical abnormality of the foot. Having ultrasound, electrical stimulation, whirlpool, and massage done on the foot. The foot may be injected with corticosteroids mixed with a local anesthetic in order to reduce pain. Relief may be only temporary, however, if the mechanical irritation is not also corrected. Injections with other types of medications such as alcohol, phenol, or vitamin B12 are sometimes used.
When medications or other treatments do not work, podiatric surgery may be required. The most common surgical procedure for treating Morton?s neuroma is a neurectomy, in which part of the nerve tissue is removed. Although this procedure effectively removes the original neuroma, sometimes scar tissue known as a stump neuroma forms at the site of the incision. This may result in tingling, numbness, or pain following surgery. Surgery is effective in relieving or reducing symptoms for Morton?s neuroma patients in about 75% to 85% of all cases. Occasionally, minimally invasive radio frequency ablation is also used to treat Morton's neuroma.
Wearing shoes that fit properly and that have plenty of room in the toe area may help prevent Morton's neuroma.