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Morton’s Neuroma

Morton’s Neuroma

Also referred to as: Mortons Neuromas, Morton Neuromas, Morton’s Neuroma.

What is Mortons Neuroma?

A neuroma is a thickening of nerve tissue that may develop in various parts of the body. The most common neuroma in the foot is a Morton’s neuroma, which occurs between the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma. “Intermetatarsal” describes its location in the ball of the foot between the metatarsal bones. Neuromas may also occur in other locations in the foot.

The thickening, or enlargement, of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates enlargement of the nerve, eventually leading to permanent nerve damage.

Causes

Anything that causes compression or irritation of the nerve can lead to the development of a neuroma. One of the most common offenders is wearing shoes that have a tapered toe box, or high-heeled shoes that cause the toes to be forced into the toe box.

People with certain foot deformities – bunions, hammertoes, flatfeet, or more flexible feet – are at higher risk for developing a neuroma. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running or court sports. An injury or other type of trauma to the area may also lead to a neuroma.

Symptoms

If you have a Morton’s Neuroma, you may have one or more of these symptoms where the nerve damage is occurring:

-  Tingling, burning, or numbness.

-  Pain.

-  A feeling that something is inside the ball of the foot.

-  A feeling that there’s something in the shoe or a sock is bunched up.

The progression of a Morton’s neuroma often follows this pattern:

-  The symptoms begin gradually. At first they occur only occasionally, when wearing narrow-toed shoes or performing certain aggravating activities.

-  The symptoms may go away temporarily by removing the shoe, 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

To arrive at a diagnosis, Tom will obtain a thorough history of your symptoms and examine your foot. During the physical examination, he will attempt to reproduce your symptoms by manipulating your foot. Other tests or imaging studies may be performed. 
The best time to see Tom is early in the development of symptoms. Early diagnosis of a Morton’s neuroma greatly lessens the need for more invasive treatments and may avoid surgery.

Non-surgical Treatment

Tom has been treating Mortons Neuroma for many years and has developed a treatment pathway based on clinical experience and the most up to date research. He will first determine how long you’ve had the neuroma and evaluate its stage of development. Treatment approaches vary according to the severity of the problem. 
For mild to moderate neuromas, treatment options may include:

Padding

Padding techniques provide support for the metatarsal arch, thereby lessening the pressure on the nerve and decreasing the compression when walking.

Icing

Placing an icepack on the affected area helps reduce swelling.

Orthotic Devices

Custom orthotic devices provide the support needed to reduce pressure and compression on the nerve.

Activity Modifications

Activities that put repetitive pressure on the neuroma should be avoided until the condition improves.

Shoe Modifications

Wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels.

Medications

Oral no steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.

Injection Therapy

Treatment may include injections of cortisone, local anesthetics or other agents.

If you think you have a Morton’s Neuroma it is better to have it see to early to maximize the chance of conservative treatment options solving your foot problems. 
To book an appointment with Tom contact us on: 07738 225 653, via email: info@swpodiatry.co.uk