A Morton's neuroma usually develops between the third and fourth toes. Less commonly, it develops between the second and third toes. Other locations are rare. It also is rare for a Morton's neuroma to develop in both feet at the same time. The condition is much more common in women than men, probably as a result of wearing high-heeled, narrow-toed shoes. This style of shoe tends to shift the bones of the feet into an abnormal position, which increases the risk that a neuroma will form. Being overweight also increases the risk of a Morton's neuroma.
When a nerve is pinched between bones, the result is swelling of the nerve. It is this swelling which is referred to as a Neuroma. When the condition occurs in the foot, it is known as a Morton?s Neuroma. Morton?s Neuroma is technically not a tumor. Rather, it is a thickening of the tissue that surrounds the digital nerves leading to the toes. These nerves allow for physical sensation on the skin of the toes. The region of inflammation is found where the digital nerve passes under the ligament connecting the toe bones (metatarsals) in the forefoot. Morton?s Neuroma commonly develops between the third and fourth toes, generally as a result of ongoing irritation, trauma or excessive pressure. In some cases, the second and third toes are involved. Morton?s Neuroma is confined to one foot in most cases, though it can occur in both, particularly in athletes such as runners.
What are the symptoms of Morton?s neuroma? A sharp or stinging pain between the toes when standing or walking. Pain in the forefoot between the toes. Swelling between the toes. Tingling (?pins and needles?) and numbness. Feeling like there is a ?bunched up sock? or a pebble or marble under the ball of the foot.
A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose a Morton's neuroma. Investigations such as an X-ray, ultrasound, MRI, CT scan or bone scan may sometimes be used to assist with diagnosis, assess the severity of the injury and rule out other conditions.
Non Surgical Treatment
Nonsurgical treatment is tried first. Your doctor may recommend any of the following. Padding and taping the toe area, shoe inserts, changes to footwear, for example wearing shoes with wider toe boxes or flat heels, Anti-inflammatory medicines taken by mouth or injected into the toe area, nerve blocking medicines injected into the toe area, other painkillers, physical therapy. Anti-inflammatories and painkillers are not recommended for long-term treatment. In some cases, surgery is needed to remove the thickened tissue and inflammed nerve. This helps relieve pain and improve foot function. Numbness after surgery is permanent.
If conservative treatments haven't helped, your doctor might suggest injections. Some people are helped by the injection of steroids into the painful area. In some cases, surgeons can relieve the pressure on the nerve by cutting nearby structures, such as the ligament that binds together some of the bones in the front of the foot. Surgical removal of the growth may be necessary if other treatments fail to provide pain relief. Although surgery is usually successful, the procedure can result in permanent numbness in the affected toes.
Always warm-up thoroughly before vigorous athletics. Avoid activities that cause pain. Stretch and strengthen the feet through gradual exercise.