Morton's Neuroma

Definition: Morton’s neuroma is a painful condition affecting the ball of the foot, most commonly between the third and fourth toes. It involves the thickening of the tissue around one of the nerves leading to the toes, which can cause sharp, burning pain and discomfort.

Causes:

• Repetitive Stress: Activities that place repetitive pressure on the forefoot, such as running or high-impact sports.
• Footwear: Tight, narrow, or high-heeled shoes that squeeze the toes and put pressure on the nerve.
• Foot Abnormalities: Conditions such as bunions, hammertoes, flat feet, or high arches can contribute to the development of Morton’s neuroma.

Symptoms:

• Sharp, burning pain in the ball of the foot
• Tingling or numbness in the toes
• A feeling of standing on a pebble or a fold in the sock
• Pain that worsens with activity or when wearing tight shoes

Diagnosis:

• Physical Examination: Assessing pain and tenderness in the affected area, often by squeezing the foot.
• Imaging Tests: Ultrasound or MRI may be used to visualize the neuroma and rule out other conditions.

Treatment:

• Footwear Changes: Switching to shoes with a wider toe box and low heels to reduce pressure on the nerve.
• Orthotic Devices: Using custom insoles or pads to provide support and alleviate pressure on the affected area.
• Medications: Anti-inflammatory drugs to reduce pain and swelling.
• Injections: Corticosteroid injections to reduce inflammation and pain.
• Physical Therapy: Exercises and techniques to relieve symptoms and improve foot function.
• Surgery: In severe cases, surgical removal of the neuroma may be necessary if conservative treatments fail.

Prognosis: Most people with Morton’s neuroma find relief with conservative treatments, especially when addressed early. Changes in footwear and activity modification are crucial for preventing recurrence. In cases where surgery is required, the prognosis is generally good, though it may take time for full recovery and return to normal activities.