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.
The exact cause is unknown. Doctors believe the following may play a role in the development of this condition. Wearing tight shoes and high heels. Abnormal positioning of toes. Flat feet. Forefoot problems, including bunions and hammer toes. High foot arches. Morton neuroma is more common in women than in men.
The primary symptoms include sharp, shooting pain, numbness or paresthesia in the forefoot and extending distally into the toes, typically in the region of the third and fourth toes. Symptoms are aggravated with narrow toe box shoes or those with high heels. There is usually a reduction of symptoms when walking barefoot or wearing shoes with an appropriately wide toe box. Symptoms are also aggravated with shoes that are tied too tight.
Metatarsal bones will be examined clinically, and often an x-ray will be taken to assess the particular case and ensure against other conditions, including fracture. When the foot is examined by a doctor, he may feel a characteristic ?click,? referred to as Mulder?s sign, and the interspaces between toe bones will often be tender. The doctor may put pressure on these areas to localize the site of pain and test for other conditions, including calluses or stress fractures. Range of motion tests will also be applied to rule out arthritis or joint inflammations. X-rays may be required to ensure there are no stress fractures or arthritis within the joints that join the toes to the foot. Tenderness in one or more metatarsal bones may imply a pre-stress fracture or stress-fracture. An ultrasound scan may be used to confirm diagnosis of Morton?s Neuroma, as x-ray will not detect the condition, (but can confirm that the bones are uninjured).
Non Surgical Treatment
Pain is the main reason that you seek treatment for a neuroma. Analgesics may help. Inflammation it best eased via ice therapy and techniques or exercises that deload the inflammed structures. Anti-inflammatory medications may help. Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include: ice, electrotherapy, acupuncture, deloading taping techniques, soft tissue massage and orthotics to offload the irritated nerve. One of the biggest factors in relieving pain may be changing or modifying your footwear. This may mean adding felt, foam or gel products to your shoe to help offload the area, or looking at avoiding tight fitting heels or shoes.
Surgery is occasionally required when the conservative treatment is not able to relieve your symptoms, particularly if you have had pain for more than 6 months. 80% of patients who require surgery report good results, with 71% of people becoming pain-free.