What is it?

Morton’s Neuroma is often called and “inter-digital” neuroma because it is found between the toes of the foot, most commonly the 3rd and 4th toes.

It is a result of an entrapped nerve which becomes inflamed due to constant irritation from the surrounding bony structures.  If this trauma persists, soft tissue adaptation will result in the thickening of the nerve.

Symptoms associated with a neuroma include a dull burning sensation radiating towards the toes, or even a stinging sensation that can be described as being similar to an electric shock.  Pain under the ball of the foot is also often experienced.

What causes it?

Constant trauma from the surrounding bones damages the nerve branches and therefore the body will try and protect the nerve by increasing the thickness of the nerves insulating sheath.  This constant abuse to the nerve branch is present when the foot is unstable.  This means that there is an imbalance in the structure of the foot causing abnormal motion. This abnormal motion is the primary factor associated with the formation of a neuroma.

How is it treated?

A neuroma should always be treated conservatively initially. This means trying to remove the causative factors.

Your Podiatrist will outline a treatment program for you which will consist of two or more of the following steps.

Assess tight fitting footwear

This causes lateral pressure on the bones, increasing the irritation on the nerve.

Address the foot and lower limb biomechanics

This involves diagnosing the cause of the foot instability and prescribing a customised orthotic to separate the toe bones and stabilise the foot.

Anesthetic / Cortisone injection

This is done when the above treatments are insufficient.  The trauma is sometimes so great that conservative treatment cannot control the inflammation. An appropriate referral is arranged if this treatment is necessary.

Surgery

This is the last and most permanent course of action.  An incision is made in the top of the foot and the entrapped nerve excised.  Obviously the results are permanent, but not with out some side affects.  Your Podiatrist can discuss this course of treatment with you should it be required.

So remember!  A neuroma is a nerve that is being traumatized by a poorly functioning foot and treating the cause of this condition is paramount.

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