Morton’s Neuroma
What is a Morton’s neuroma?
A Morton’s neuroma refers to compression of the interdigital nerve, typically between the 3rd and 4th toes. Overtime, this compression and irritation can lead to scarring of the nerve and the tissue surrounding the nerve. The nerve can become thickened and irritated as a result.
What causes a Morton’s neuroma?
A Morton’s neuroma is caused by compression and swelling of the nerve running between the toes. The compression may be the result of decreased space between metatarsals, chronic overloading of the area due to a tight heel cord or calf muscle, ligament instability, clawtoe deformity, and congenital foot deformities.
What are the symptoms of a Morton’s neuroma?
Patients with a Morton’s neuroma often complain of numbness in the affected toes, burning in the ball of the foot that may radiate to the toes, pain with tight fitting shoes or shoes with a heel and pain with prolonged standing and walking.
How is a Morton’s neuroma diagnosed?
A Morton’s neuroma is diagnosed by thorough history and physical examination. X-rays are typically ordered to assess for any abnormality of the joints, the toes and the bones of the foot.
How is a Morton’s neuroma treated?
Nonsurgical
Conservative treatment for a Morton’s neuroma is typically very successful for the majority of patients. The main goal is to relieve pressure on the nerve and diminish repetitive loading through the painful area. This is often achieved with rest, ice, activity modification, anti-inflammatory medications, metatarsal pads, comfort shoes with a low heel and wide toe box, calf stretching, orthotics, cortisone injections and occasionally walking boots.
Operative treatment
Operative treatment can be necessary in patients who fail conservative therapy. The surgery involves releasing tissue compressing the nerve and at times removing a portion of the diseased nerve (neurectomy).