Overview
Morton's neuroma is a swollen, inflamed nerve in the foot.Morton's neuroma causes a "burning" sharp pain on the bottom of the foot. Treatments for Morton's neuroma include resting the foot, better-fitting shoes, anti-inflammation medications, ice packs, and operation. A neuroma is growth (benign tumor) that arises in nerve cells. A Morton's neuroma is a swollen, inflamed nerve located between the bones at the ball of the foot. The most common location of a Morton's neuroma is in either the second or the third spacing from the base of the big toe.
Causes
Experts are not sure what exactly causes Morton's neuroma. It seems to develop as a result of irritation, pressure or injury to one of the digital nerves that lead to the toes, which triggers a body response, resulting in thickened nerve tissue (neuroma). Feet conditions/situations that can cause the bones to rub against a nerve include high-heeled shoes, especially those over 2 inches (5cm), or a pointed or tight toe box which squash the toes together. This is probably why the condition is much more common in females than in males. High-arched foot, people whose feet have high arches are much more likely to suffer from Morton's neuroma than others. Flat feet, the arch of the foot collapses. The entire sole of the foot comes into complete or near-complete contact with the ground. A bunion, a localized painful swelling at the base of the big toe, which enlarges the joint. Hammer toe, a deformity of the proximal interphalangeal joint of the second, third, or fourth toe causing it to be permanently bent. Some high-impact sporting activities including running, karate, and court sports. Any sport that places undue pressure on the feet. Injuries, an injury or other type of trauma to the foot may lead to a neuroma.
Symptoms
If you have a Morton's neuroma, you will probably have one or more of these symptoms. Tingling, burning, or numbness. A feeling that something is inside the ball of the foot, or your sock is bunched up. Pain that is relieved by removing your shoes. A Morton's Neuroma often develops gradually. At first the symptoms may occur only occasionally, when wearing narrower shoes or performing certain activities. The symptoms may go away temporarily by massaging the foot or by avoiding aggravating shoes or activities. Over time the symptoms progressively worsen and may persist for several days or weeks. The symptoms become more intense as the neuroma enlarges and the temporary changes in the nerve become permanent.
Diagnosis
Morton?s neuroma can be identified during a physical exam, after pressing on the bottom of the foot. This maneuver usually reproduces the patient?s pain. MRI and ultrasound are imaging studiesthat can demonstrate the presence of the neuroma. An x-ray may also be ordered to make sure no other issues exist in the foot. A local anesthetic injection along the neuroma may temporarily abolish the pain, and help confirm the diagnosis.
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.
Surgical Treatment
Surgery may be considered in patients who have not responded adequately to non-surgical treatments. Your foot and ankle surgeon will determine the approach that is best for your condition. The length of the recovery period will vary, depending on the procedure performed. Regardless of whether you?ve undergone surgical or nonsurgical treatment, your surgeon will recommend long-term measures to help keep your symptoms from returning. These include appropriate footwear and modification of activities to reduce the repetitive pressure on the foot.
Prevention
Although the exact causes of neuromas are not completely known, the following preventive steps may help. Make sure your exercise shoes have enough room in the front part of the shoe and that your toes are not excessively compressed. Wear shoes with adequate padding in the ball of the foot. Avoid prolonged time in shoes with a narrow toe box or excessive heel height (greater than two inches).
Morton's neuroma is a swollen, inflamed nerve in the foot.Morton's neuroma causes a "burning" sharp pain on the bottom of the foot. Treatments for Morton's neuroma include resting the foot, better-fitting shoes, anti-inflammation medications, ice packs, and operation. A neuroma is growth (benign tumor) that arises in nerve cells. A Morton's neuroma is a swollen, inflamed nerve located between the bones at the ball of the foot. The most common location of a Morton's neuroma is in either the second or the third spacing from the base of the big toe.
Causes
Experts are not sure what exactly causes Morton's neuroma. It seems to develop as a result of irritation, pressure or injury to one of the digital nerves that lead to the toes, which triggers a body response, resulting in thickened nerve tissue (neuroma). Feet conditions/situations that can cause the bones to rub against a nerve include high-heeled shoes, especially those over 2 inches (5cm), or a pointed or tight toe box which squash the toes together. This is probably why the condition is much more common in females than in males. High-arched foot, people whose feet have high arches are much more likely to suffer from Morton's neuroma than others. Flat feet, the arch of the foot collapses. The entire sole of the foot comes into complete or near-complete contact with the ground. A bunion, a localized painful swelling at the base of the big toe, which enlarges the joint. Hammer toe, a deformity of the proximal interphalangeal joint of the second, third, or fourth toe causing it to be permanently bent. Some high-impact sporting activities including running, karate, and court sports. Any sport that places undue pressure on the feet. Injuries, an injury or other type of trauma to the foot may lead to a neuroma.
Symptoms
If you have a Morton's neuroma, you will probably have one or more of these symptoms. Tingling, burning, or numbness. A feeling that something is inside the ball of the foot, or your sock is bunched up. Pain that is relieved by removing your shoes. A Morton's Neuroma often develops gradually. At first the symptoms may occur only occasionally, when wearing narrower shoes or performing certain activities. The symptoms may go away temporarily by massaging the foot or by avoiding aggravating shoes or activities. Over time the symptoms progressively worsen and may persist for several days or weeks. The symptoms become more intense as the neuroma enlarges and the temporary changes in the nerve become permanent.
Diagnosis
Morton?s neuroma can be identified during a physical exam, after pressing on the bottom of the foot. This maneuver usually reproduces the patient?s pain. MRI and ultrasound are imaging studiesthat can demonstrate the presence of the neuroma. An x-ray may also be ordered to make sure no other issues exist in the foot. A local anesthetic injection along the neuroma may temporarily abolish the pain, and help confirm the diagnosis.
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.
Surgical Treatment
Surgery may be considered in patients who have not responded adequately to non-surgical treatments. Your foot and ankle surgeon will determine the approach that is best for your condition. The length of the recovery period will vary, depending on the procedure performed. Regardless of whether you?ve undergone surgical or nonsurgical treatment, your surgeon will recommend long-term measures to help keep your symptoms from returning. These include appropriate footwear and modification of activities to reduce the repetitive pressure on the foot.
Prevention
Although the exact causes of neuromas are not completely known, the following preventive steps may help. Make sure your exercise shoes have enough room in the front part of the shoe and that your toes are not excessively compressed. Wear shoes with adequate padding in the ball of the foot. Avoid prolonged time in shoes with a narrow toe box or excessive heel height (greater than two inches).