Morton’s 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 at the base of the toes due to constant irritation from the surrounding bony structures. If this trauma persists, soft tissue adaptation will result in the thickening of the nerve.
Generally symptoms involve pain and numbness in a specific spot in the ball of the foot, sometimes radiating to the toes.
What causes it?
Constant trauma from the surrounding bones damages the nerve branches and therefore the body will try and protect the nerve by increasing the thickness of the sheath surrounding the nerve. 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 is the primary factor associated with the formation of a neuroma.
Tight fitting footwear is another common cause for Morton’s Neuroma. Tight footwear compresses the bones in the foot and the nerves that run between them leading to nerve damage.
If you suffer from Morton’s Neuroma, you would probably experience
- Pain under a specific location in the ball of the foot
- Tingling or shooting pain in the toes
- Radiation of pain
- A hardened lump under the ball of your foot
- Arch pain and tightness
A neuroma should always be initially treated conservatively. First, this means trying to remove the causative factors. Your Foot Comfort podiatrist will outline a treatment programme for you which consists of two or more of the following steps.
- Assess tight fitting footwear. This causes a lateral pressure on the bones, increasing the irritation on the nerve. A lot of comfort can be also gained by reducing down the shoe heel height.
- Address the foot and lower limb biomechanics. This involves diagnosing the cause of the foot instability and prescribing customized shoe inserts called an orthotic appliance to correct abnormal function.
- Anesthetic/Cortisone Injections. This is done when the above treatments are insufficient. The trauma is sometimes so great that conservative treatment cannot control the inflammation. Appropriate referral is arranged if this treatment is necessary.
This is the last and most permanent course of action. An incision is made in the top of the foot and the entrapped nerve excised. Obviously the results are permanent but not without some side effects. Your Podiatrist can discuss this course of treatment with you should it be required.