Morton\u2019s neuroma is a benign thickening (formation of fibrous tissue) of the common plantar digital nerve located in the forefoot. It most commonly occurs between the 3rd and 4th metatarsals and causes pain, a burning sensation, and numbness during walking or when wearing tight shoes.<\/p>\n\n\n\n
\nCauses and Risk Factors<\/strong><\/p>\n\n\n\n
Morton\u2019s neuroma is caused by repeated pressure or irritation of the nerve, leading to thickening and inflammation of the fibrous tissue surrounding it.<\/p>\n\n\n\n
1. Variations in foot mechanics<\/strong><\/p>\n\n\n\n
\u2013 Flat feet or pes cavus, which affect proper pressure distribution across the foot.<\/p>\n\n\n\n
\u2013 Toe deformities (e.g. hammer toes, hallux valgus), which create additional pressure on the nerve.<\/p>\n\n\n\n
2. Inappropriate footwear<\/strong><\/p>\n\n\n\n
\u2013 Tight or narrow-toed shoes, which compress the toes together.<\/p>\n\n\n\n
\u2013 High heels, which increase pressure on the forefoot.<\/p>\n\n\n\n
3. Prolonged strain<\/strong><\/p>\n\n\n\n
\u2013 Running, dancing, or sports involving repetitive jumping, which increase friction around the nerve.<\/p>\n\n\n\n
\u2013 Prolonged standing, especially on hard surfaces.<\/p>\n\n\n\n
4. Injuries and inflammation<\/strong><\/p>\n\n\n\n
\u2013 Previous foot injuries that may have caused scar tissue to form around the nerve.<\/p>\n\n\n\n
Symptoms<\/strong><\/p>\n\n\n\n
\u2013 Pain in the forefoot, often described as burning or stabbing pain.<\/p>\n\n\n\n
\u2013 A sensation that there is a small \u201cpebble\u201d inside the shoe.<\/p>\n\n\n\n
\u2013 Numbness or tingling in the toes, especially in the 3rd and 4th toes.<\/p>\n\n\n\n
\u2013 Worsening of the pain when wearing tight shoes or after prolonged walking.<\/p>\n\n\n\n
\u2013 Relief when removing the shoes or massaging the foot.<\/p>\n\n\n\n
Diagnosis<\/strong><\/p>\n\n\n\n
Diagnosis is made through:<\/p>\n\n\n\n
\u2013 Clinical examination, during which the podiatrist presses on the area to assess pain and tenderness.<\/p>\n\n\n\n
\u2013 Mulder\u2019s sign:<\/strong> Pressure is applied to the forefoot, and a characteristic click may be elicited if a neuroma is present.<\/p>\n\n\n\n
\u2013 Imaging tests:<\/strong><\/p>\n\n\n\n
Ultrasound, to detect thickening of the nerve.<\/p>\n\n\n\n
Magnetic resonance imaging (MRI), if symptoms are severe or the diagnosis is unclear.<\/p>\n\n\n\n
Management and Treatment<\/strong><\/p>\n\n\n\n
1. Conservative methods<\/strong><\/p>\n\n\n\n
\u2013 Footwear modification<\/strong><\/p>\n\n\n\n
\u2013 Choosing wide shoes with soft soles that do not compress the toes.<\/p>\n\n\n\n
\u2013 Avoiding tight, narrow-toed, or high-heeled shoes.<\/p>\n\n\n\n
\u2013 Orthotic insoles, which help restore proper foot alignment and offload the affected area.<\/p>\n\n\n\n
\u2013 Physiotherapy and stretching<\/strong><\/p>\n\n\n\n
Exercises to strengthen the foot and improve support.<\/p>\n\n\n\n
Heat therapy or massage, to relax the plantar muscles.<\/p>\n\n\n\n
\u2013 Avoidance of excessive strain and adjustment of activities.<\/p>\n\n\n\n
\u2013 Anti-inflammatory medication (ibuprofen, naproxen) for temporary pain relief.<\/p>\n\n\n\n
2. Minimally invasive treatments<\/strong><\/p>\n\n\n\n
\u2013 Cortisone injections: These provide relief from inflammation, but they are not a permanent solution.<\/p>\n\n\n\n
\u2013 Alcohol injections (Alcohol Sclerosing Therapy): A sclerosing treatment that gradually reduces the size of the neuroma.<\/p>\n\n\n\n
3. Surgical treatment (in severe or persistent cases)<\/strong><\/p>\n\n\n\n
When conservative treatments fail and the pain significantly affects daily life, surgical removal of the neuroma may be required.<\/p>\n\n\n\n
Prevention<\/strong><\/p>\n\n\n\n
\u2013 Choosing appropriate footwear: comfortable, with good support and enough room for the toes.<\/p>\n\n\n\n
\u2013 Regular rest and stretching to avoid excessive strain on the feet.<\/p>\n\n\n\n
\u2013 Use of orthotic insoles if there is predisposition or anatomical variation in the forefoot.<\/p>\n\n\n\n
\u2013 Avoidance of prolonged use of tight or high-heeled shoes.<\/p>\n\n\n\n
When to Visit the Podiatrist<\/strong><\/p>\n\n\n\n
\u2013 If the pain persists for more than 2\u20133 weeks despite footwear changes.<\/p>\n\n\n\n
\u2013 If there is marked numbness or a burning sensation in the forefoot.<\/p>\n\n\n\n
\u2013 If the sensation of a \u201cstone in the shoe\u201d becomes increasingly intense.<\/p>\n\n\n\n
\u2013 If the pain makes walking difficult or affects your daily life.<\/p>\n<\/blockquote>\n\n\n\n
Morton\u2019s neuroma<\/strong> is a painful but treatable condition. Conservative treatments are often effective, while in advanced cases, surgery may provide a definitive solution.<\/p>\n","protected":false},"excerpt":{"rendered":"
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