What is a Morton’s Neuroma?

Morton’s Neuroma is often called an “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 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 a neuroma treated?

Morton’s neuroma treatment should always involve a conservative approach initially. Many neuromas under a certain size respond well to conservative treatment including orthotic therapy with neuroma pads, foot mobilisation and sometimes accupuncture. If a neuroma is very large, surgery may be the only solution.

Your Podiatrist will attempt to remove the causative factors. A treatment program will be designed which will generally involve the steps listed below. These include:

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.

Foot Mobilisation

Current research is showing very positive results with a course of foot mobilisation.

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.

Contact Podiatry Care if you suspect you have a Morton’s Neuroma.