A neuroma is a thickening of nerve tissue that may develop in various parts of the body. 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. Neuromas may also occur in other locations in the foot. MortonThe thickening, or enlargement, of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates enlargement of the nerve, eventually leading to permanent nerve damage.
Morton’s neuroma seems to occur in response to irritation, pressure or injury to one of the nerves that lead to your toes. Factors that appear to contribute to Morton’s neuroma include. High heels. Wearing high-heeled shoes or shoes that are tight or ill fitting can place extra pressure on your toes and the ball of your foot. Certain sports. Participating in high-impact athletic activities such as jogging or running may subject your feet to repetitive trauma. Sports that feature tight shoes, such as snow skiing or rock climbing, can put pressure on your toes. Foot deformities. People who have bunions, hammertoes, high arches or flatfeet are at higher risk of developing Morton’s neuroma.
The primary symptoms include sharp, shooting pain, numbness or paresthesia in the forefoot and extending distally into the toes, typically in the region of the third and fourth toes. Symptoms are aggravated with narrow toe box shoes or those with high heels. There is usually a reduction of symptoms when walking barefoot or wearing shoes with an appropriately wide toe box. Symptoms are also aggravated with shoes that are tied too tight.
Your podiatric physician will begin by taking a history of your problem. Assist him or her by describing your condition as well as you can. Keep track of when the symptoms started and how, any changes you?ve noted (whether the pain has gotten worse, or whether other symptoms have appeared as well, etc.). If you?ve noticed that certain activities or footwear make things worse or bring about additional symptoms, be sure to mention that. If you work in specific footwear, or if you participate in any certain sports, bring the shoes you use. Your doctor may be able to learn quite a lot about your condition that way!
Non Surgical Treatment
To help relieve the pain associated with Morton’s neuroma and allow the nerve to heal, consider the following self-care tips. Take anti-inflammatory medications. Over-the-counter nonsteroidal anti-inflammatory medications, such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve), can reduce swelling and relieve pain. Try ice massage. Regular ice massage may help reduce pain. Freeze a water-filled paper cup or plastic foam cup and roll the ice over the painful site. Change your footwear. Avoid high heels or tight shoes. Choose shoes with a broad toe box and extra depth. Take a break. For a few weeks, reduce activities such as jogging, aerobic exercise or dancing that subject your feet to high impact.
Interdigital neurectomy (removal of the diseased nerve) in right hands, should give satisfactory results almost all the time. Some of the reasons behind failure is when not enough nerve is dissected, mistakes in initial diagnosis, or bad handling of adjacent nerves, tendons and joint capsules during the operation. It is very common and acceptable to have some numbness in the area where the nerve used to be. This never causes any discomfort and often gets better in few years. It is crucial to address the biomechanical pathologies underlying the impingement of the nerve during and after the surgery.