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Morton's Neuroma

I’m not even sure who Morton was, but he must have a heck of a pain in the ball of his foot! Morton’s neuroma is actually "perineural fibrosis." In English, this is chronic scarring around a nerve. This scarring is almost an onion skin formation of scar tissue layered with fluid around a small interdigital nerve. The more fluid, the more scar, the more pain you experience. This is a compression problem. The nerve is compressed with scar and the ligament that connects the metatarsal (the long bones connected to your toes). Permanent nerve damage can occur in neuromas.

What causes neuromas? Anything that compresses your toes together can cause a neuroma. Commonly, it is a combination of faulty biomechanics coupled with improper shoe gear or repetitive stress activities that lead to neuromas. People with other foot deformities such as bunions and hammertoes are ay higher risk for neuromas. Injuries such as stress fractures and sprains can also cause neuromas. Whatever the underlying cause, neuromas usually progress from a minor irritation to a big pain in the foot!

Symptoms of neuromas usually start with an annoying "bunched up sock" feeling in the ball of your foot. Taking off your shoes can alleviate these early symptoms, but somewhere along the way; the pain stays. It progresses to numbness, burning and pain in the ball of the foot which radiates to your toes. Electric shock treatment probably feels a lot like an interdigital neuroma. This can occur in between the 3rd and 4th toes , most commonly; but also occurs in between the 2nd and 3rd toes especially in those patients with other deformities like bunions.

Diagnosis is obtained through physical examination and x-rays (to rule-out a fracture or other bone abnormality). Occasionally ultrasound is used to identify a neuroma. MRI’s are usually not cut small enough to see a small interdigital neuroma, so are usually not helpful.

Treatments include changes in shoe gear, injections of anti-inflammatories, padding, functional orthotics to decrease the abnormal biomechanical stress, and surgery. Advances have been made in cryosurgery and alcohol sclerosis injections. These can be discussed with your podiatrist.

When is surgery needed for neuromas? If you have pain every day, in every pair of shoes you own (including your athletic shoes) and you have treated your condition with conservative therapy without any relief; it’s time to discuss surgery. Surgery should never be contemplated without pain and activity limitations. There are many advances in foot surgery and varied procedures depending on your foot type, the stage of your deformity, your activity level, your medical history, and your age. Make an appointment to discuss surgery with your podiatrist if you have progressing symptoms. If conservative treatment fails, surgery can successfully remove the neuroma allowing you to go back to your normal shoe gear and activities.

Call or contact us on the website for an appointment today to get your questions answers. Regardless of your treatment, long-term orthotic devices and shoe gear modifications will be needed to decrease the chance of recurrence. Be smart, seek medical attention early in your neuroma symptoms to avoid long-term complications.