Overview
A neuroma develops when a nerve is compressed, injured or pinched, causing swelling and pain. A neuroma in the area between the third and fourth toes, or between the second and third toes, is known as a Morton?s neuroma. Morton?s neuroma causes sharp, burning pain and numbness in the toes and foot. You may feel like you?ve stepped on a tiny hot coal and can?t get rid of it. At the same time, you?ll have the disconcerting experience of not being able to feel your toes. Sometimes the nerve tissue becomes so thickened you can feel or see a lump.
Causes
Some experts believe that other foot conditions may also be associated with Morton's neuroma. This is because other conditions may cause the metatarsal bones to rub against the nerve in your foot. Foot problems that may increase your risk of developing Morton's neuroma include abnormally positioned toes, high arches, where the arch or instep of your foot is raised more than normal, flat feet, low arches or no arches at all, bunions a bony swelling at the base of the toe. Hammer toe, where the toe is bent at the middle joint. Being active and playing sport can make the painful symptoms of Morton's neuroma worse. In particular, running or sports that involve running, such as racquet sports, can place extra pressure on the nerve in your foot, which can aggravate the problem.
Symptoms
Patients with neuroma may develop pain on the bottom of the forefoot, most commonly under the 3rd and 4th toes, though any toe may be affected. The pain may be dull and mild or severe and sharp. The toes may feel ?numb? as times, especially the area between the 3rd and 4th toes. A classic complaint is that patients feel as if they are ?walking on a stone or pebble? and/or ?feel as if the sock is rolled up in the shoe.? Pain is often worse when walking barefoot.
Diagnosis
If you suspect Morton?s Neuroma, it is essential that you confirm your suspicions by consulting with a podiatric physician. Don?t wait for the symptoms to go away for good (even if they tend to come and go). Also, remember that many conditions have similar symptoms, and only a professional can tell the difference.
Non Surgical Treatment
Orthotics and corticosteroid injections are widely used conservative treatments for Morton?s neuroma. In addition to traditional orthotic arch supports, a small foam or fabric pad may be positioned under the space between the two affected metatarsals, immediately behind the bone ends. This pad helps to splay the metatarsal bones and create more space for the nerve so as to relieve pressure and irritation. It may however also elicit mild uncomfortable sensations of its own, such as the feeling of having an awkward object under one's foot. Corticosteroid injections can relieve inflammation in some patients and help to end the symptoms. For some patients, however, the inflammation and pain recur after some weeks or months, and corticosteroids can only be used a limited number of times because they cause progressive degeneration of ligamentous and tendinous tissues.
Surgical Treatment
For severe or persistent pain, you may need surgery to remove the neuroma. Once the nerve is gone, you permanently lose feeling in the affected area. One alternative to surgery is to undergo neurolysis injections. These use chemical agents to block pain signals. Another alternative is to take a prescription pain reliever that alleviates nerve pain.
A neuroma develops when a nerve is compressed, injured or pinched, causing swelling and pain. A neuroma in the area between the third and fourth toes, or between the second and third toes, is known as a Morton?s neuroma. Morton?s neuroma causes sharp, burning pain and numbness in the toes and foot. You may feel like you?ve stepped on a tiny hot coal and can?t get rid of it. At the same time, you?ll have the disconcerting experience of not being able to feel your toes. Sometimes the nerve tissue becomes so thickened you can feel or see a lump.
Causes
Some experts believe that other foot conditions may also be associated with Morton's neuroma. This is because other conditions may cause the metatarsal bones to rub against the nerve in your foot. Foot problems that may increase your risk of developing Morton's neuroma include abnormally positioned toes, high arches, where the arch or instep of your foot is raised more than normal, flat feet, low arches or no arches at all, bunions a bony swelling at the base of the toe. Hammer toe, where the toe is bent at the middle joint. Being active and playing sport can make the painful symptoms of Morton's neuroma worse. In particular, running or sports that involve running, such as racquet sports, can place extra pressure on the nerve in your foot, which can aggravate the problem.
Symptoms
Patients with neuroma may develop pain on the bottom of the forefoot, most commonly under the 3rd and 4th toes, though any toe may be affected. The pain may be dull and mild or severe and sharp. The toes may feel ?numb? as times, especially the area between the 3rd and 4th toes. A classic complaint is that patients feel as if they are ?walking on a stone or pebble? and/or ?feel as if the sock is rolled up in the shoe.? Pain is often worse when walking barefoot.
Diagnosis
If you suspect Morton?s Neuroma, it is essential that you confirm your suspicions by consulting with a podiatric physician. Don?t wait for the symptoms to go away for good (even if they tend to come and go). Also, remember that many conditions have similar symptoms, and only a professional can tell the difference.
Non Surgical Treatment
Orthotics and corticosteroid injections are widely used conservative treatments for Morton?s neuroma. In addition to traditional orthotic arch supports, a small foam or fabric pad may be positioned under the space between the two affected metatarsals, immediately behind the bone ends. This pad helps to splay the metatarsal bones and create more space for the nerve so as to relieve pressure and irritation. It may however also elicit mild uncomfortable sensations of its own, such as the feeling of having an awkward object under one's foot. Corticosteroid injections can relieve inflammation in some patients and help to end the symptoms. For some patients, however, the inflammation and pain recur after some weeks or months, and corticosteroids can only be used a limited number of times because they cause progressive degeneration of ligamentous and tendinous tissues.
Surgical Treatment
For severe or persistent pain, you may need surgery to remove the neuroma. Once the nerve is gone, you permanently lose feeling in the affected area. One alternative to surgery is to undergo neurolysis injections. These use chemical agents to block pain signals. Another alternative is to take a prescription pain reliever that alleviates nerve pain.