Morton’s Neuroma

Morton's neuroma is a painful condition characterized by a thickening of the tissue around a nerve leading to the toes, typically between the third and fourth toes. Common symptoms include:

• Sharp or burning pain in the ball of the foot, often described as feeling like a pebble in the shoe.
• Numbness or tingling in the affected toes.
• Pain that worsens with walking, wearing tight or narrow shoes, or standing for long periods.
• Sensation of a lump or swelling between the toes.
• Difficulty bearing weight on the affected foot.

Morton's neuroma is believed to develop due to irritation or compression of the digital nerve in the foot, leading to thickening of the nerve tissue. Several factors can contribute to this condition, including:

• Wearing tight or narrow shoes that squeeze the toes together and put pressure on the nerve.
• High-heeled shoes that force the toes into an unnatural position and increase stress on the forefoot.
• Certain foot deformities, such as bunions or hammertoes, that alter the alignment of the toes and contribute to nerve compression.
• Repetitive stress or trauma to the forefoot, common in activities like running or dancing.
• Footwear with inadequate support or cushioning, leading to increased pressure on the ball of the foot.

Diagnosing Morton's neuroma typically involves a comprehensive evaluation by a healthcare professional. The diagnosis may include:

• Medical history: Discussion of the patient’s medical history, as well as current symptoms, including pain location, duration, and aggravating factors.
• Physical examination: Palpation of the foot to identify areas of tenderness, swelling, or thickening of the nerves.
• Diagnostic tests: Imaging studies such as X-rays, ultrasound, or magnetic resonance imaging (MRI) may be ordered to visualize the foot structures and rule out other conditions like stress fractures or arthritis.
• Diagnostic injections: A local anesthetic injection may be used to temporarily numb the affected area, helping to confirm the diagnosis by providing relief from pain.

Treatment for Morton's neuroma aims to alleviate pain, reduce inflammation, and improve foot function. Common treatment options include:

• Footwear modifications: Wearing shoes with a wide toe box and low heels can help reduce pressure on the forefoot and alleviate symptoms.
• Orthotic devices: Custom-made or over-the-counter orthotic inserts can provide support, cushioning, and proper alignment of the foot to relieve pressure on the affected nerve.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be prescribed to reduce pain and inflammation.
• Injection therapy: Corticosteroid injections into the affected area can help alleviate pain and inflammation, providing temporary relief.
• Physical therapy: Stretching and strengthening exercises, as well as ultrasound therapy, may help improve foot mechanics and reduce nerve irritation.
• Radiofrequency ablation: In some cases, radiofrequency ablation may be performed.
• Surgery: If conservative treatments fail to provide relief, surgical removal of the neuroma may be considered. This procedure involves excising the affected nerve tissue to alleviate symptoms and restore foot function.