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What Causes Mortons Neuroma

Overview

Morton neuromaMorton's neuroma is a swollen or thickened nerve in the ball of your foot. When your toes are squeezed together too often and for too long, the nerve that runs between your toes can swell and get thicker. This swelling can make it painful when you walk on that foot. High-heeled, tight, or narrow shoes can make pain worse. Sometimes, changing to shoes that give your toes more room can help.

Causes

Morton's Neuroma is a foot condition caused from an abnormal function of the foot that leads to bones squeezing a nerve usually between the 3rd and 4th metatarsal heads. Symptoms of Morton's Neuroma often occur during or after you have been placing significant pressure on the forefoot area, while walking, standing, jumping, or sprinting. This condition can also be caused by footwear selection. Footwear with pointed toes and/or high heels can often lead to a neuroma. Constricting shoes can pinch the nerve between the toes, causing discomfort and extreme pain.

Symptoms

Often, no outward signs (such as a lump or unusual swelling) appear from the condition. Neuroma pain is most often described as a burning discomfort in the forefoot. Aching or sudden shooting pain in the forefoot is also common. All running sports, especially distance running can leave an athlete vulnerable to Morton?s Neuroma, which may appear or flare up in the middle of a run or at the end. The sufferer often has the desire to remove his shoe and rub the afflicted foot. Should the Neuroma be of sufficient size, or if footwear is particularly tight or uncomfortable, the painful condition may be present during normal walking. Numbness in the foot may precede or accompany Neuroma pain.

Diagnosis

To arrive at a diagnosis, the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor attempts to reproduce your symptoms by manipulating your foot. Other tests or imaging studies may be performed. The best time to see your foot and ankle surgeon is early in the development of symptoms. Early diagnosis of a Morton?s neuroma greatly lessens the need for more invasive treatments and may avoid surgery.

Non Surgical Treatment

Treatment options vary with the severity of each neuroma, and identifying the neuroma early in its development is important to avoid surgical correction. For simple, undeveloped neuromas, a pair of thick-soled shoes with a wide toe box is often adequate treatment to relieve symptoms, allowing the condition to diminish on its own. For more severe conditions, however, additional treatment or surgery may be necessary to remove the tumor. The primary goal of most early treatment regimens is to relieve pressure on areas where a neuroma develops. Your podiatric physician will examine and likely X-ray the affected area and suggest a treatment plan that best suits your individual case. Padding and Taping. Special padding at the ball of the foot may change the abnormal foot function and relieve the symptoms caused by the neuroma. Medication. Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the neuroma. Orthotics. Custom shoe inserts made by your podiatrist may be useful in controlling foot function. Orthotics may reduce symptoms and prevent the worsening of the condition.Morton

Surgical Treatment

The ultimate success of a Morton?s neuroma treated surgically is somewhat unclear. This is likely due to the idea that in most instances a ?Morton?s neuroma? is actually more than just an isolated nerve problem but rather consitutes a metatarsalgia where other structures (such a as the MTP joints) are also problematic, not just the nerve. Therefore, addressing the nerve as well as the other components of a metatarsalgia may offer a better chance of surgical success. However, like many conditions in foot and ankle, it is ideal if this condition can be managed without surgery.

Prevention

Always warm-up thoroughly before vigorous athletics. Avoid activities that cause pain. Stretch and strengthen the feet through gradual exercise.
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