Overview
Morton's neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. Morton's neuroma may feel as if you are standing on a pebble in your shoe or on a fold in your sock. Morton's neuroma involves a thickening of the tissue around one of the nerves leading to your toes. This can cause a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb. High-heeled shoes have been linked to the development of Morton's neuroma. Many people experience relief by switching to lower heeled shoes with wider toe boxes. Sometimes corticosteroid injections or surgery may be necessary.
Causes
There are many reasons to develop a neuroma. Improper shoe gear is probably the most likely cause. Repetitive activity and excessive pressure on the ball of the foot are common. Heredity and genetic factors may also be involved. In many cases the structure of the foot may predispose the condition. Associated conditions that may cause neuroma include: bunion, hammer toes, ligament laxity, and/or a tight calf muscle. Some patients may have thinning of the fat pad on the ball of the foot, which may result in increased pressure of the nerves. Tight pointy shoes (and high heels) without padding may induce pain in the ball of the foot. Neuroma may occur suddenly, or develop over time.
Symptoms
Patients will complain of numbness, a ?pins and needles? type of tingling and loss of sensation in the toes. Burning pain in the ball of the foot that may radiate into the toes. The pain generally intensifies with activity or wearing shoes. Night pain is rare. There may also be numbness in the toes, or an unpleasant feeling in the toes. Runners may feel pain as they push off from the starting block. High-heeled shoes, which put the foot in a similar position to the push-off, can also aggravate the condition. Tight, narrow shoes also aggravate this condition by compressing the toe bones and pinching the nerve.
Diagnosis
Based on the physical examination, your doctor usually can diagnose a Morton's neuroma without additional testing. A foot X-ray may be ordered to make sure that there isn't a stress fracture, but it will not show the actual neuroma. If the diagnosis is in doubt, your doctor may request magnetic resonance imaging (MRI) of the foot.
Non Surgical Treatment
Most patients' symptoms subside when they change footwear to a wide soft shoe with a metatarsal support inside to relieve the pressure on the involved area. If this treatment fails, a cortisone injection into the nerve is occasionally helpful.
Surgical Treatment
Surgery to excise the neuroma is usually performed under general anaesthetic in a day surgery facility. After surgery you will have to keep your foot dry for two weeks. Generally neuroma surgery allows for early weight bearing and protection in some type of post op shoe gear. Some neuromas may reoccur, but this is rare. Most studies on patient satisfaction after neuroma surgery show approximately 90% reduction of pain and about 85% of all patients rated the overall satisfaction with the results as excellent or good.
Morton's neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. Morton's neuroma may feel as if you are standing on a pebble in your shoe or on a fold in your sock. Morton's neuroma involves a thickening of the tissue around one of the nerves leading to your toes. This can cause a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb. High-heeled shoes have been linked to the development of Morton's neuroma. Many people experience relief by switching to lower heeled shoes with wider toe boxes. Sometimes corticosteroid injections or surgery may be necessary.
Causes
There are many reasons to develop a neuroma. Improper shoe gear is probably the most likely cause. Repetitive activity and excessive pressure on the ball of the foot are common. Heredity and genetic factors may also be involved. In many cases the structure of the foot may predispose the condition. Associated conditions that may cause neuroma include: bunion, hammer toes, ligament laxity, and/or a tight calf muscle. Some patients may have thinning of the fat pad on the ball of the foot, which may result in increased pressure of the nerves. Tight pointy shoes (and high heels) without padding may induce pain in the ball of the foot. Neuroma may occur suddenly, or develop over time.
Symptoms
Patients will complain of numbness, a ?pins and needles? type of tingling and loss of sensation in the toes. Burning pain in the ball of the foot that may radiate into the toes. The pain generally intensifies with activity or wearing shoes. Night pain is rare. There may also be numbness in the toes, or an unpleasant feeling in the toes. Runners may feel pain as they push off from the starting block. High-heeled shoes, which put the foot in a similar position to the push-off, can also aggravate the condition. Tight, narrow shoes also aggravate this condition by compressing the toe bones and pinching the nerve.
Diagnosis
Based on the physical examination, your doctor usually can diagnose a Morton's neuroma without additional testing. A foot X-ray may be ordered to make sure that there isn't a stress fracture, but it will not show the actual neuroma. If the diagnosis is in doubt, your doctor may request magnetic resonance imaging (MRI) of the foot.
Non Surgical Treatment
Most patients' symptoms subside when they change footwear to a wide soft shoe with a metatarsal support inside to relieve the pressure on the involved area. If this treatment fails, a cortisone injection into the nerve is occasionally helpful.
Surgical Treatment
Surgery to excise the neuroma is usually performed under general anaesthetic in a day surgery facility. After surgery you will have to keep your foot dry for two weeks. Generally neuroma surgery allows for early weight bearing and protection in some type of post op shoe gear. Some neuromas may reoccur, but this is rare. Most studies on patient satisfaction after neuroma surgery show approximately 90% reduction of pain and about 85% of all patients rated the overall satisfaction with the results as excellent or good.