Overview
Morton's neuroma is a condition that affects one of the nerves that run between the long bones (metatarsals) in the foot. The exact cause is not certain. Symptoms include pain, burning, numbness and tingling between two of the toes of the foot. About a quarter of people just need simple treatments including modification of their footwear. Sometimes surgery is needed for long-standing (chronic) symptoms.
Causes
Morton's Neuroma is a caused by pressure, abnormal function/motion or an imbalance in the structure of the foot such as flat feet, that causes an abnormal pressure on the structures and the nerves in the ball of the foot. It most commonly affects the nerve that goes to the 2nd 3rd or 4th toes. The squeezing of the nerve from abnormal motion leads to a protective thickening of the sheath that protects the nerve. Symptoms of Morton's Neuroma often occur during or after activities that cause a sidewards squeezing of the ball of the foot or from pressure such as walking, standing, or playing sport. Since squeezing is a common cause of the condition, shoes such as pointed toes or high heels can often lead to a neuroma. Shoes that are constricting, even tight sneakers, can pinch the nerve between the toes, causing inflammation and pain.
Symptoms
The symptoms of Morton?s Neuroma tend to come and go over time. They are typically exacerbated by physical activity or by wearing certain shoes. Morton?s Neuroma symptoms include sharp pain in the ball of the foot, pain radiating to the tips of the toes, burning pain in the second, third, or fourth toes, numbness in the toes, sensation of a lump between the toes.
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
Common treatments involve wearing different shoes or using arch supports. Resting the foot, massaging the toes and using an ice pack may work for some people. A GP or a podiatrist (foot specialist) may also recommend anti-inflammatory painkillers or a course of steroid injections. Numbing injections, in which alcohol and a local anaesthetic are injected into the affected area of the foot, may also be effective. In extreme cases, when the condition does not respond to treatment, day case surgery may be needed.
Surgical Treatment
Recently, an increasing number of procedures are being performed at specialist centers under radiological or ultrasound guidance. Recent studies have shown excellent results for the treatment of Morton's neuroma with ultrasound guided steroid injections, ultrasound guided sclerosing alcohol injections, ultrasound guided radiofrequency ablation and ultrasound guided cryo-ablation.
Prevention
Wearing proper footwear that minimizes compression of the forefoot can help to prevent the development of and aggravation of a Morton's neuroma.
Morton's neuroma is a condition that affects one of the nerves that run between the long bones (metatarsals) in the foot. The exact cause is not certain. Symptoms include pain, burning, numbness and tingling between two of the toes of the foot. About a quarter of people just need simple treatments including modification of their footwear. Sometimes surgery is needed for long-standing (chronic) symptoms.
Causes
Morton's Neuroma is a caused by pressure, abnormal function/motion or an imbalance in the structure of the foot such as flat feet, that causes an abnormal pressure on the structures and the nerves in the ball of the foot. It most commonly affects the nerve that goes to the 2nd 3rd or 4th toes. The squeezing of the nerve from abnormal motion leads to a protective thickening of the sheath that protects the nerve. Symptoms of Morton's Neuroma often occur during or after activities that cause a sidewards squeezing of the ball of the foot or from pressure such as walking, standing, or playing sport. Since squeezing is a common cause of the condition, shoes such as pointed toes or high heels can often lead to a neuroma. Shoes that are constricting, even tight sneakers, can pinch the nerve between the toes, causing inflammation and pain.
Symptoms
The symptoms of Morton?s Neuroma tend to come and go over time. They are typically exacerbated by physical activity or by wearing certain shoes. Morton?s Neuroma symptoms include sharp pain in the ball of the foot, pain radiating to the tips of the toes, burning pain in the second, third, or fourth toes, numbness in the toes, sensation of a lump between the toes.
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
Common treatments involve wearing different shoes or using arch supports. Resting the foot, massaging the toes and using an ice pack may work for some people. A GP or a podiatrist (foot specialist) may also recommend anti-inflammatory painkillers or a course of steroid injections. Numbing injections, in which alcohol and a local anaesthetic are injected into the affected area of the foot, may also be effective. In extreme cases, when the condition does not respond to treatment, day case surgery may be needed.
Surgical Treatment
Recently, an increasing number of procedures are being performed at specialist centers under radiological or ultrasound guidance. Recent studies have shown excellent results for the treatment of Morton's neuroma with ultrasound guided steroid injections, ultrasound guided sclerosing alcohol injections, ultrasound guided radiofrequency ablation and ultrasound guided cryo-ablation.
Prevention
Wearing proper footwear that minimizes compression of the forefoot can help to prevent the development of and aggravation of a Morton's neuroma.