The neuroma is a non-cancerous growth of nerve tissues which can form tumors. A neuroma can occur in any part of the body. Neuroma formed between the second and third intermetatarsal spaces of an intermetatarsal plantar nerve is called Morton’s neuroma. The nerve gets entrapped between the two toes resulting in pain and numbness in the region. Dr. Thomas George Morton was the first scientist to diagnose the condition; hence it is named after him as Morton’s neuroma. It is also called as Morton’s metatarsalgia. Researchers have a different opinion, as they the outgrown tissue to be referred to as neuroma or fibroma, as fibrous tissue is formed in the nerves of the ball of the foot. The condition causes sharp pain which may sting, burn or feel numb.
How Painful Is Morton’s Neuroma?
Morton’s neuroma is a painful condition resulting due to compression of metatarsal heads as the nerve does not reach the destination. It affects the ball of the foot. Lifestyle changes like changing the footwear and reducing physical activity can be helpful in relieving the pain. A simple pain starts to progress and impairs any physical activity. The pain can be dull which becomes sharp on applying pressure. Traditional measures to reduce pain are considered, if there is pain alleviation then surgical removal of nerves should be considered. The surgery can result in permanent numbness in the toes.
Morton’s neuroma occurs due to development of pressure on the plantar nerves, injury or irritation. People wearing high heels, ill-fitted shoes or tight shoes are at risk of developing Morton’s neuroma. Athletes who are involved in high-level of activities such as jogging or running can cause trauma and put pressure on your toes. People who have natural deformities such as bunions, hammertoes, high arches or flat feet are at risk of developing Morton’s neuroma. It is better to consult a doctor when the pain lasts longer without any improvement. Women wearing high heels often suffer from Morton’s neuroma. People may experience Morton’s neuroma as a lump in the foot without any visible physical enlargement. It feels like standing on a stone or a stone is stuck in your shoes. The pain radiates from the ball of the foot towards toes.
Changing the footwear from high heels to low heels can help in alleviating pain. It is characterized by thickening of the tissues around the plantar nerve resulting in the formation of a lump. Magnetic resonance imaging (MRI) or ultrasound confirms the diagnosis of Morton’s neuroma.
The pain due to Morton neuroma does not allow any further pressure. The person will find it difficult to perform any weight-bearing activities. Pain will become prevalent throughout the activity which bears pressure on the foot and limits even walking. This leads to a sedentary lifestyle where people spend most of their time sitting or lying on the bed. Patients with Morton neuroma develop irregular waking pattern due to painful toes. This can also result in other problems such as arthritis and back pain.
The treatment of Morton’s neuroma depends on the severity of the disease. In order to reduce pain, doctors aim at reducing pressure on the plantar nerve with the help of Arch supports and foot pads. Doctors will also advise custom designed shoes to reduce pressure on the foot.
The pain can be reduced by applying ice packs or ice passage. Avoid your regular walk, jogging, and exercise. Oral pain medications such as ibuprofen and naproxen can help reduce pain and swelling. Adequate rest should be taken to allow the healing of nerves. Injection of the corticosteroids in the painful area reduces inflammation. Morton neuroma can be treated by non-surgical procedures such as ultrasound-guided radiofrequency ablation, cryosurgery, and neurolytic injections. In people who have undergone the surgical procedure, the relapse is common and can happen in up to 50% cases. The treatment also depends upon the structure of the foot and if surgery is performed how much nerve damage exists.
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