MORTON’S NEUROMA

A Morton’s neuroma stems from having excess pressure on the nerves of your foot, usually from wearing shoes that are too tight. It is actually a small ball of nerve bundles that have formed a benign tumor on the ball of the foot, usually located in the web space between the third and fourth toes. It is painful, even though you can’t see anything on the outside and often feels as though you are standing on a small rock.
​The pain of Morton’s neuroma is sharp in the area of the neuroma but you can also experience a burning pain near the ball of your foot. Your toes may also be affected by feeling numb or by burning.

Signs and Symptoms of a Morton’s Neuroma

There are usually no signs that you have the neuroma. The diagnosis based on the type and quality of pain you are experiencing. As mentioned, it may feel like there is a small rock in your shoe associated with burning in the ball of the foot that travels to your toes. Your toes may be numb or tingly because the nerve is affected.

Causes of a Morton’s Neuroma

Women tend to get this problem more often than men because they wear high heels that put pressure on the nerves traveling to the toes. Women tend to wear shoes that are too tight, which causes pinching of the nerves. You can also get a Morton’s neuroma if you are a jogger or runner and repeatedly strike your foot against the pavement. Any sport that involves wearing tight shoes like rock climbing or skiing can put extra pressure on the nerves. Those who already have foot problems like hammer toes, bunions, flat feet or high arches are at a greater risk of developing a Morton’s neuroma.

Diagnosing Morton’s Neuroma

The diagnosis can be made clinically by pushing on your foot, looking for a lump or tender area. Sometimes the doctor will use the back of a pencil and push the tissue between the toes, feeling for areas of tenderness.
​Things like x-rays, ultrasound, and MRI scans can be used to diagnose the disorder. X-rays are used mostly to make sure there isn’t something else going on like a stress fracture of one of your metatarsal bones. An ultrasound can be used on the foot to highlight the actual neuroma within the tissues. MRI scans are also good tests for soft tissue problems. It uses a strong magnet and radio waves to give two and three dimensional images of the foot. This is an expensive test so it isn’t used much to diagnose a Morton’s neuroma. Often the physical examination is all that is necessary.

Treating a Morton’s Neuroma

The treatment of a Morton’s neuroma varies according to how severe your symptoms are. The doctor may prescribe supports for the arch of the foot or special pads you wear inside the shoe to take the pressure off the nerve. You will be asked not to wear high heels and should wear shoes that give the foot plenty of room. Custom made molds of the foot may be made to support the foot and to decrease pain.

​If these things don’t help, the doctor may inject the neuroma with corticosteroids to relieve the inflammation surrounding the nerve bundle. The doctor can also do surgery to cut away tissue that is putting excess pressure on the neuroma. This spreads out the bones and keeps them from pushing on the neuroma. In severe cases, the neuroma can be cut out using surgery. This will relieve the pain but, because it involves cutting the nerve, there can be numbness of the toes that lasts indefinitely.

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