Morton's neuroma, also known as interdigital neuroma or intermetatarsal neuroma, is a painful condition that affects the nerves in the foot, most commonly between the third and fourth toes. It involves a thickening of the tissue around one of the nerves leading to the toes. This thickening, or fibrosis, can cause compression and irritation of the nerve, leading to pain and other symptoms.
Key Features
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Location: Morton's neuroma typically occurs between the third and fourth toes of the foot, although it can also affect the area between other toes.
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Symptoms:
- Pain or discomfort: Often described as a burning or shooting pain in the ball of the foot or between the toes.
- Numbness or tingling: Some individuals may experience numbness or tingling in the toes affected by the neuroma.
- Feeling of a lump: Patients may feel as though there is a lump or a foreign object in the ball of the foot.
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Aggravating Factors: Activities that involve repetitive pressure or irritation to the forefoot, such as walking, running, or wearing tight or narrow shoes with high heels, can exacerbate symptoms.
Causes and Risk Factors
The exact cause of Morton's neuroma is not always clear, but it is believed to result from repetitive stress or injury to the nerve in the foot. Several factors may contribute to the development of Morton's neuroma:
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Foot Structure: Certain foot deformities or conditions, such as bunions, hammertoes, or flat feet, can increase the risk of developing Morton's neuroma.
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Footwear: Wearing tight, narrow, or high-heeled shoes can compress the toes and increase pressure on the nerves in the forefoot.
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Activities: High-impact activities that involve repetitive stress on the feet, such as running or jogging, may contribute to the development of Morton's neuroma.
Diagnosis
Diagnosing Morton's neuroma typically involves a combination of medical history, physical examination, and imaging studies. A healthcare provider may:
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Perform a Physical Examination: Palpate the area between the toes to identify areas of tenderness or swelling.
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Order Imaging Studies: X-rays, ultrasound, or magnetic resonance imaging (MRI) may be used to visualize the foot and assess the size and location of the neuroma.
Treatment
Treatment for Morton's neuroma aims to relieve pain and reduce pressure on the affected nerve. Conservative treatment options may include:
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Footwear Modification: Wearing shoes with a wider toe box and lower heels to reduce pressure on the forefoot.
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Orthotic Devices: Custom-made shoe inserts (orthotics) or metatarsal pads can help redistribute pressure and provide support to the foot.
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Medications: Over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs) may help reduce pain and inflammation.
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Corticosteroid Injections: Injections of corticosteroids into the area around the neuroma can help reduce inflammation and relieve pain.
Surgical Treatment
If conservative measures fail to provide relief, surgical intervention may be considered. Surgical options for Morton's neuroma include:
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Neurectomy: Surgical removal of the affected nerve or part of the nerve to relieve pressure and alleviate symptoms.
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Decompression Surgery: Surgical release of the ligament or tissue compressing the nerve to reduce pressure and improve symptoms.
Prognosis
The prognosis for Morton's neuroma varies depending on the severity of the condition and the effectiveness of treatment. Conservative measures are often successful in relieving symptoms, but surgical intervention may be necessary in some cases. With appropriate treatment, most individuals with Morton's neuroma can experience significant relief from pain and resume normal activities.
Prevention
To prevent Morton's neuroma or reduce the risk of recurrence:
- Wear properly fitted shoes with adequate room for the toes and low heels.
- Avoid high-heeled shoes or shoes with narrow toe boxes, especially for long periods.
- Maintain a healthy weight to reduce pressure on the feet and lower limbs.
- Practice good foot hygiene and wear supportive footwear during high-impact activities.
Conclusion
Morton's neuroma is a painful condition caused by compression and irritation of the nerves in the foot, most commonly between the third and fourth toes. While it can significantly impact quality of life, conservative measures such as footwear modification, orthotics, and medications can often provide relief. In severe cases, surgical intervention may be necessary to alleviate symptoms and restore function to the foot. Early diagnosis and appropriate treatment are important for managing Morton's neuroma and preventing complications. If you experience persistent foot pain or discomfort, consult a healthcare provider for evaluation and management