Struggling with Morton’s neuroma? Dr. Nick Argerakis, DPM, FACFAS, offers expert treatment options to alleviate pain and help you regain mobility. Take the first step towards a pain-free life today.
The simplest step to address Morton’s neuroma is modifying activities that aggravate it. Ready to take charge of your life? Contact us at (732)-320-9173 to schedule an appointment and start your journey to pain-free living.
Key Takeaways
- Morton’s Neuroma is a painful condition caused by a thickened nerve, typically between the third and fourth toes, leading to sharp pain, tingling, and the sensation of a pebble in the shoe.
- Risk Factors include foot structure abnormalities, tight footwear, high-impact activities, and certain health conditions.
- Non-surgical treatments include footwear changes, orthotics, medications, corticosteroid injections, physical therapy, and activity modifications to alleviate symptoms.
- Surgical Options include neurectomy (nerve removal) and decompression surgery (nerve release), with the choice depending on the severity and patient’s condition.
- Effective Treatment is possible with the right care and intervention, with expert foot surgeons offering tailored solutions for relief.
What Is Morton’s Neuroma?
- Morton’s neuroma occurs when the nerve between the third and fourth toes thickens.
- This causes sharp, burning pain in the ball of the foot, tingling, numbness in the toes, or the sensation of a pebble in your shoe.
- Symptoms worsen with walking or running and improve with rest.
- This condition is most common in middle-aged women due to shoe choices, though it can affect anyone.
Causes and Risk Factors
Several factors can contribute to Morton’s neuroma:
- Foot Structure – Flat feet, high arches, bunions, or hammertoes may increase risk.
- Footwear – High heels and narrow shoes that compress the toes often lead to nerve irritation.
- Activities – High-impact sports like running, tennis, or basketball can strain the forefoot.
- Injury – Acute trauma or repetitive micro-injuries to the foot may damage nerves.
- Other Factors – Obesity, prolonged standing, and certain illnesses, such as diabetes or rheumatoid arthritis, can also increase risk.
Symptoms
Common signs of Morton’s neuroma include:
- Sharp, Burning Pain – Often felt in the ball of the foot and aggravated by physical activity.
- Tingling or Numbness – Discomfort that may be intermittent or constant.
- Pebble-in-Shoe Sensation – A frequent description from patients.
- Swelling Between Toes – Some may notice visible swelling or a small lump.
Diagnosis
Our diagnostic process for Morton’s neuroma begins with a thorough medical history and physical examination. During the exam, we check for tenderness, sensitivity, or the presence of Mulder’s sign, a clicking sensation when pressure is applied to the foot.
To confirm the diagnosis, imaging tests may be used. X-rays help rule out fractures, arthritis, or bone spurs. Ultrasound provides detailed images of thickened nerve tissue, while an MRI assesses the size and location of the neuroma.
Treatment Options
Non-Surgical Treatments
When Morton’s neuroma is suspected, non-surgical treatments are typically recommended to manage symptoms before considering surgery. Footwear changes are often the first step. Wearing shoes with a wider toe box, low heels, and better arch support can help reduce pressure on the affected nerve. Tight-fitting shoes and high heels should be avoided. Custom orthotics are also effective in distributing pressure more evenly, and metatarsal pads can alleviate compression by lifting and separating the bones in the forefoot.
Medications like over-the-counter pain relievers, such as ibuprofen or naproxen, help reduce pain and inflammation. For more intense pain, stronger medications may be prescribed. Corticosteroid injections provide temporary relief by reducing pain and inflammation, and physical therapy is highly beneficial. Exercises that improve foot strength and flexibility, along with treatments like ultrasound or deep tissue massage, can help alleviate pain. Finally, activity modification is crucial; minimizing high-impact activities that aggravate the condition can reduce stress on the affected nerve.
Surgical Treatments
When non-surgical treatments fail to relieve pain or if the symptoms become too severe, surgery may be required. There are two main surgical options for Morton’s neuroma:
Neurectomy
This is the most common procedure, which involves partial amputation of the nerve to relieve pain. The procedure can be performed using either a dorsal or plantar approach. The dorsal approach involves making an incision on the top of the foot, which avoids the weight-bearing area, making early recovery more comfortable. The plantar approach involves an incision on the sole of the foot, providing direct access to the neuroma but may be more painful post-surgery due to weight-bearing.
Decompression Surgery
This procedure aims to reduce pressure on the nerve by releasing the ligaments that are compressing it, without removing the nerve itself. The Hampton Medical Nerve Release involves making an incision and dissecting the ligaments around the nerve. This is a less invasive option, suitable for patients with milder symptoms or those who wish to avoid nerve removal.
Both surgical procedures are typically done on an outpatient basis, meaning patients can go home the same day. The choice of procedure depends on the severity of the condition and the surgeon’s expertise.
Conclusion
Morton’s neuroma can be painful, but with proper treatment, relief is possible. Our expert foot surgeons at New Jersey Foot Surgeons are equipped with advanced tools to help you regain comfort. If you’re struggling with Morton’s neuroma, contact us today at (732)-320-9173 to schedule an appointment and take the first step toward a pain-free life.
