The neuroma can prove to be excruciating and it can limit one’s actions thus making it almost impossible to perform even basic tasks. Patients should not view these factors as a hindrance to their treatment and normal living, but rather step up for treatment and get their normal life back. The simplest and most obvious treatment for Morton’s Neuroma is to stop practicing certain activities that you once enjoyed for they are no longer possible due to the neuroma.
Now, do not let Morton’s neuroma act as a hindrance to your life; arise from your wheelchair and take charge of your life now. Our whole-spectrum plan to assist you does not limit itself to helping you sign up but instead will continue to support you through every phase of the process. We are available at (732)-320-9173 should you wish to organize an appointment and start your new life without pain with a beautiful smile.
What is Morton’s Neuroma?
Morton’s neuroma is developed when the nerve that leads to your toes, in between your third and fourth toes, has thickened. This thickened tissue and the condition that produces it can impinge on the nerve, and this will manifest itself as sharp, burning pain in the ball of the foot; tingling or numbness in the toes; and the distinct impression of a pebble in your shoe. The discomfort can be felt when the patient is walking or running and improves when one is at rest or if one takes off the shoe that is causing pressure on the forefoot.
This condition can involve any part of the foot but is most often seen in the third and fourth toes due to the configuration of the foot and how its ‘edge’ performs work during movement. Murom’s neuroma is common in middle-aged people, and it is most frequent among females because of their choice of shoes.
Causes and Risk Factors
The precise cause for Morton’s neuroma is not completely known but is postulated to be caused by biomechanical abnormalities in conjunction with trauma as well as systemic influences. Several factors may contribute to its development:
- Foot Structure: Other risk factors include specific foot alignment, where persons with flat feet (pes planus), high-arched feet (pes cavus), bunion, or hammertoe are likely to develop Morton’s neuroma. These deviations from normal ankle biomechanics can cause delays in the proper positioning of the limb and loading extra force on the nerves in the forefoot.
- Footwear: High-heeled or narrow shoes that conform the toes in a narrow-toed shape also put pressure and squash the nerves on the foot and can cause a neuroma to form. There is also advice that shoes with a thin toe area or poorly cushioned medial arch area can also worsen the complication.
- Activities: It is advisable to avoid rigorous exercises that cause high pressure on the feet like running, dancing, or playing sports that put weight, particularly on the metatarsals e. g. basketball and tennis which might trigger the development of Morton’s neuroma. These activities tend to exert a lot of stress on the forefoot, a part of the body that is known to be prone to nerve compression and inflammation.
- Injury: A direct injury or micro-trauma resulting from acute or chronic micro-traumatic forces, for example, due to excessive foot activities like running may lead to injury of the nerves together with the surrounding tissues, hence developing a neuroma.
Other risk factors may include obesity, length of standing, and certain illnesses (such as rheumatoid arthritis or diabetes) that may also predispose a person to develop Morton’s neuroma.
Symptoms
Common symptoms of Morton’s neuroma include:
- Sharp, Burning Pain: Pain is usually experienced in the inner portion of the foot, though it can extend into the toes. This typically gets worse when one engages in physical activities that require the use of the feet and gets better when one is passive or Removes shoes.
- Tingling or Numbness: This is marked by pain in the form of burning or numbness in the affected toes which may be occasionally or constantly experienced.
- Feeling of a Pebble in Your Shoe: It is not uncommon to hear patients report that they feel like they are standing on a little stone or a marble, though the shoe bottom is empty.
- Swelling Between the Toes: Sometimes, the condition may be felt, for instance, some patients may experience swelling or even a mass in the area between the toes.
Diagnosis
The preliminary form of treatment may involve the following steps where our foot surgeon will first take a detailed medical history and then do a physical examination to diagnose Morton’s neuroma. During your physical examination, the doctor feels around the painful area to see if there is sensitivity to touch or if there is a growth of a mass within the foot or toe; the doctor also tries to apply pressure on the painful part of your foot to numb it or to look for a clicking sound known the Mulder’s sign which is associated with Morton’s neuroma foot condition.
Apart from the physical examination, we come up with a conclusive diagnosis and try to eliminate all other possibilities. These tests can include:
- X-rays: Although X-rays do not show a neuroma, they can help exclude other pathologies, including fractures, arthritis, bone spurs, or other conditions that may manifest with similar presenting symptoms.
- Ultrasound: This imaging technique involves imparting sound wave energy that produces images of the soft tissues in the foot in 3D view helping the doctor to see the thickened nerve tissue.
- MRI (Magnetic Resonance Imaging): MRI preserves the structural integrity of bones and soft tissues; therefore, an MRI is beneficial in establishing the presence of a neuroma and its size and location.
Treatment Options
Non-Surgical Treatments
When Morton’s neuroma is suspected there are less invasive procedures that may be applied to manage the symptoms before surgery is contemplated. These treatments include:
- Footwear Changes: Surgical procedures for the treatment of neuromas include an adjustment of footwear with a wider toe box, low-heeled shoes, and better arch support which tends to decrease pressure on the affected nerve and minimize signs. There are certain factors that the sexes are advised to avoid; this includes high-heeled and tight-fitting shoes.
- Orthotic Devices: Custom shoe inserts (orthotics) can help distribute pressure more evenly across the foot, reducing stress on the affected nerve. Metatarsal pads placed in the shoe can also help lift and separate the bones in the forefoot, decreasing nerve compression.
- Medication: Take painkillers such as ibuprofen and naproxen that are available over the counter and are NSAIDs to help reduce pain and inflammation. At times, we may recommend over-the-counter pain relievers; more intensive forms of pain medication might also be recommended.
- Corticosteroid Injections: Oral medications cannot be used to treat tendonitis, although injected steroid solutions into the tender area infuse pain and inflammation for a short time. Such injections can be administered again, in case they are required but commonly used for the short term.
- Physical Therapy: If you have foot or toe issues, exercises and stretches that focus on the muscles in the foot can improve the strength and flexibility to alleviate the ailment. Measures such as the use of ultrasound therapy or deep tissue massage may also help in the reduction of pain.
- Activity Modification: Restriction or minimization of tasks that are likely to worsen the pain and status of the nerve, exercises like high-impact activities may be appropriate in alleviating pain.
Surgical Treatments
Even when non-surgical therapies do not help or the pain is too intense, surgery might be needed to alleviate suffering. There are two main surgical approaches for Morton’s neuroma:
1. Neurectomy: Usually this surgery is the most frequent type of operation that is performed for Morton’s neuroma. This one is done through partial amputation to relieve pain associated with a particular nerve. This can be achieved either by dorsal or plantar incision depending on the location of the deformity or preference of the surgeon. There are different types of surgical approaches used in the treatment of spinal disorders and the selection of the appropriate approach depends on the conditions, preferences, and work experience of the neurosurgeon, as well as the condition of the patient, the type and location of the spine pathology.
- Dorsal Approach: In this process, our surgeon cuts through the skin of the foot at its dorsum point or the anterior surface of the foot. The benefit of doing so is that the patient can walk much more comfortably throughout the early phases of the healing process since the wound does not have to be placed over the area of the foot that bears most of a person’s weight.
- Plantar Approach: This consists of having a cut on the sole of the affected foot. Although this approach would give more straightforward access to the neuroma, the postoperative phase may be uncomfortable in forming an incision on the plantar aspect of the foot which is used to bear weight.
2. Decompression Surgery: This procedure entails untying some of the ligaments that are dense and compressing the nerve by providing less space for the nerve. This is less destructive to the patient than a neurectomy which has the principle of preserving the nerve rather than removing it.
- This operation, known as a Hampton Medical Nerve Release, involves the surgeon making an incision in the foot and then dissecting the ligaments around the nerve to reduce pressure on the nerve. This can be a less invasive option for patients who have less marked symptoms or who do not wish to undergo surgery that could result in damage to some nerves.
Both surgeries can be traditionally done in an outpatient fashion, and this means that you can be discharged right after the operation. There are many factors concerning the selection of the procedure which comprises the category of the disease, the general state of the patient, and the experience of the surgeon.
Conclusion
Morton’s neuroma may be a painful and agonizing condition to live with, but with the appropriate therapy, including surgical treatment, a cure is feasible. Morton’s neuroma surgery can be effectively obtained at New Jersey Foot Surgeons, where our team of expert foot surgeons is well-equipped with the knowledge and advanced tools to help patients reclaim their lives. If you are experiencing the discomfort of Morton’s neuroma, it is high time to seek the services of our qualified foot surgeons. We will guide you through the available remedies and assist you in recovering from the worry and pain. Contact us today at (732)-320-9173 to schedule your appointment and take the first step towards a pain-free life.
