Mortons neuroma is a common condition that tends to affect the region towards the toes. The pain is usually felt in the front of the foot, but it can extend to the toes. The term neuroma can be misleading due to the ending -oma being thought of as a tumor.
However, the condition is due to excessive tissue formation around a nerve that forms because of ligaments putting pressure on the nerve. The ligaments compress the nerve and the body reacts to this compression by forming excess tissue. However, this results in more compression and irritation.
The Signs and Symptoms- Pain from this condition is usually found on the foot’s ball, often between the third and fourth toes and some times between the second and third toes, but on a lesser degree. The severeness of the pain often ranges from a tingling or burning pain to a sharp one. In most cases, the pain can be felt in the toes and the ball of the foot.
Physical Exam- The foot doctor will do a series of tests to determine whether Mortons neuroma is the cause of the pain. Mulder’s Click is one common test, where the foot doctor applies their fingers on the top and bottom of the foot where the pain is situated and then squeeze the front of it at the same time. The doctor searches for a clicking sensation which causes the nerve to come into contact with the ligament and recreate the above-mentioned symptoms.
Imaging- In this procedure, the foot doctor requests for an X-ray in order to rule out any other pain causes in the area like a bone spur or a stress fracture. Give that these masses are soft tissues, diagnostic ultrasound or MRI may be used to visualise a neuroma.
Anti-inflammatory meds like Motrin can alleviate the inflammation caused by nerve irritation and thus, decrease the symptoms. However, this will just work on the symptoms and doesn’t affect the neuroma.
Padding may ideally be recommended to alleviate the pressure of the condition. There pads that are positioned between the bones in order to separate them and halt the compression of the neuroma. Padding can also be added to a shoe insert at the foot’s ball to relieve the pressure also.
When the pain becomes intolerable, and the above-mentioned methods have failed, there are various surgical alternatives. There are procedures designed to get rid of the neuroma and the portion of the nerve that is causing pain. There’s also a surgical procedure to server the ligament which crosses over the nerve. This procedure is known as nerve decompression.
These procedures are done in an out-patient facility so that the patient can go home right after the surgery is done. There’s a chance for the condition to reappear, but according to studies, this is rare and happens in 1% of patients undergoing the removal. However, additional surgery might be required if the neuroma regrows.
For more information regarding this topic, check out The Center for Morton’s Neuroma