What is Morton’s Neuroma and what causes it?
Morton’s neuroma is a painful condition located between the second and third metatarsals of the foot, affecting the entire plantar region. It involves the thickening of the tissue surrounding one of the foot’s nerves that lead to the toes. This condition causes sharp, burning pain in the sole of the foot and toes, as well as numbness.
Significant contributing factors to the development of Morton’s neuroma include high-heeled shoes or excessively tight footwear (which place excessive pressure on the metatarsals and the nerves of the foot), certain sports (such as running or skiing) that impose great stress on the feet, and various foot deformities such as hammer toe, flatfoot, and bunions.
It is most commonly observed in women aged 40-50, although it can also occur in individuals of other ages or in men.
What symptoms does Morton’s Neuroma cause?
Morton’s neuroma typically presents without visible external symptoms, aside from pain. Specifically, the pain is located in the plantar region, is burning in nature, and radiates to the toes, which may become numb or feel a burning sensation. While walking, it may feel as though one is stepping on a pebble.
How is Morton’s Neuroma diagnosed?
If the pain persists and does not improve with changes in activity or footwear, it is advisable to consult with an orthopedic specialist. During the clinical examination, the area between the second and third metatarsal bones, which is the most common location for Morton’s neuroma, will be palpated.
Your orthopedic specialist may recommend imaging tests, such as an X-ray (to identify any deformities in the forefoot), ultrasound, and magnetic resonance imaging (MRI) with contrast, which can reveal Morton’s neuroma.
What treatments are recommended for Morton’s Neuroma?
Various treatment options are available for Morton’s neuroma, depending on the severity of symptoms. Based on these, your orthopedic specialist will determine the most appropriate treatment plan.
Initially, conservative treatment is recommended, which includes wearing lower, more comfortable shoes, resting the foot, avoiding high-impact activities (such as dancing or running), minimizing standing, using appropriate insoles to absorb shock, and taking analgesic and anti-inflammatory medications.
If no improvement is seen with this approach, corticosteroid injections may be administered locally under local anesthesia. If symptoms persist, the next step is surgical intervention.
Surgical Intervention
The surgery is typically performed under local anesthesia or mild sedation, making the procedure minimally painful. The surgery lasts approximately 30 minutes, and during the procedure, the affected nerve is removed.
In general, the surgery is successful, though in some cases, it may result in permanent numbness in the affected toes. However, patients are not bothered by this numbness and report significant relief from the painful symptoms caused by Morton’s neuroma, allowing them to resume daily activities without being hindered by the discomfort.
For two weeks following the surgery, the wound must remain dry to ensure proper healing. Patients are generally able to walk immediately after surgery, provided they wear comfortable shoes.