With Morton’s Neuroma, what may start out feeling as if you’ve got a pebble in your shoe can progress and have serious consequences. This thickening of the tissue around one of the nerves leading to the toes can lead to long-term nerve damage and permanent loss of sensation. Typically, there’s no outward sign of this condition, such as a lump, so many people just ignore it. But the more a digital nerve is subjected to constant pressure, the protective tissue that sheathes it just continues to thicken to the point of restricting all weight-bearing activities. Morton’s Neuroma won’t go away on its own. This is why you should start by consulting with a skilled foot and ankle orthopedic specialist at OCC – Advanced Orthopedics & Sports Medicine Specialists in Denver, Parker, or Aurora, Colorado.
OVERVIEW
Morton’s Neuroma is a common condition of the foot that affects women around 8-to-10 times more than men. Females are at much higher risk because the anatomical construction of a female foot is inherently higher and narrower which exposes the metatarsals to extra pressure and strain. Morton’s Neuroma typically affects people between the ages of 30 and 60, although it can occur outside of this age range as well. Morton’s Neuroma symptoms are typically on one side of the foot, usually between the third and fourth toes, but the pain can extend outwards or even involve the whole side of the foot. Rarely, a foot may contain two separate Morton’s neuromas. Studies have shown that up to 33% of all patients with pain in the ball of the foot have untreated Morton’s Neuroma.
ABOUT THE FOOT
The foot is a complex mechanical structure composed of 33 joints, 26 bones, and more than a hundred muscles, tendons, and ligaments. The foot plays a crucial role in mobility, supporting the body’s weight, absorbing shock, and facilitating propulsion. It adapts to various surfaces and movements, such as walking, running, jumping, and balancing. The nerve branches in the forefoot at the level of the web spaces between the toes are called common digital plantar nerves. Due to its complex structure and heavy use, the foot is prone to various problems including Morton’s Neuroma.
WHAT IS MORTON’S NEUROMA?
A neuroma is a growth or tumor of nerve tissue. The most common neuroma in the foot is a Morton’s Neuroma, which occurs between the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma. Intermetatarsal describes its location in the ball of the foot between the metatarsal bones. Morton’s Neuroma is not a typical nerve tumor. It is a benign tumor caused by nerve degeneration and thickening of plantar digital nerves due to entrapment, such as compression and squeezing or exposure to chronic pressure.
CAUSES
- Wearing high heels
- Wearing tight shoes or shoes with a narrow toe box
- Foot deformities—people with bunions, hammertoes, flat feet, or overly flexible feet are at increased risk
- High-impact activities such as running or court sports
- Sports that require tight shoes (skiing)
- Excessive weight—being overweight increases foot strain
SYMPTOMS
- A feeling of having a pebble in the shoe or walking on razorblades
- Pain with standing or walking
- Pain that improves with removing shoes, flexing toes, or foot massage
- Tingling or numbness at the base of the 2nd to 3rd or 3rd to 4th toes
- Abnormal walking pattern (abnormal gait) due to shifting weight off painful foot
NON-SURGICAL TREATMENTS
For mild to moderate neuromas, treatment options may include:
- Padding—provides support for the metatarsal arch, lessening pressure on the nerve
- Icing
- Orthotic devices
- Activity modifications
- Shoe modifications—wearing shoes with wide toe box and avoiding narrow-toed shoes with high heels
- Medications—Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may help reduce pain and inflammation
- Corticosteroid injections have been shown to provide relief about 50% of the time
WHEN IS SURGERY INDICATED?
If symptoms do not improve or if they come back after more conservative treatments, surgery may be recommended to either remove the diseased portion of the nerve or release the tissue around the nerve. Intervention with neurectomy (removal of part of the nerve) or decompression of the nerve has the best outcomes with many studies showing an 80 to 95% success rate.
GETTING THE RIGHT DIAGNOSIS. GETTING THE RIGHT DOCTOR.
The exceptional orthopedic specialists at Advanced Orthopedics in Denver, Parker, or Aurora, Colorado, have dedicated their careers to understanding all conditions of the foot and ankle including Morton’s Neuroma. X-rays, MRIs, or even ultrasounds will help rule out arthritis or fractures, and help identify any abnormalities in soft tissue. But what sets Advanced Orthopedics apart is their skill in understanding imaging results and determining accurate diagnoses. This allows them to create a thorough and personalized treatment plan, whether that includes surgery, or not. In every way, they will be there for you. From the minute you meet them, until the time you walk back into your life pain-free. If you are suffering from foot pain, schedule an appointment with a foot specialist now.
