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Morton's Neuroma
What is Morton’s neuroma?
Morton's neuroma is a condition that affects one of the nerves in between the toes.
In Morton’s neuroma, scar tissue develops around the nerve, which becomes irritated and squashed. This leads to severe pain on the ball of the foot and at the base of the toes.
Morton's neuroma can affect either one foot or both feet. In normally tends to affect the nerve in between the third and fourth toes, but some people can get it in between the second and third toes.
The first symptom people experience is a tingling sensation in between the affected toes, which gets worse over time. This then leads to cramp in the toes and eventually a sharp shooting pain on the ball of the foot.
The pain can be so unpleasant that people with Morton's neuroma feel anxious about walking or even putting their foot on the ground. Wearing tight fitting shoes, high heels, or shoes with a pointed toe area, aggravates the pain.
How do we treat Morton's neuroma at the Mansfield Clinic?
A combination of strategies is normally used, consisting of advice regarding appropriate footwear, painkillers and anti-inflammatories, orthotic shoe inserts, and occasionally steroid injections introduced around the inflamed nerve.
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What causes Morton's neuroma?
The exact cause is unknown, but it is thought to be the metatarsal bones pressing against the nerve when the gap between the bones is narrow. This causes the nerve tissue to become thicker.
A number of other foot problems, such as flat feet, high foot arches, bunions and hammer toes, may play a role in the development of Morton's neuroma.
Sporting activities
Being active and playing sport can make the symptoms of Morton's neuroma worse. In particular, sports that involve running can place extra pressure on the nerve in the foot, thus aggravating the problem.
When to seek professional help
If you have continual tingling or persistent pain in your foot, you should seek help from the Mansfield Clinic. Dr Allfree will need to know:
- what the pain is like
- when it started
- what type of footwear you normally use
- what you do at work, and any sports that you play
He may also need further investigations such as an x-ray, or an MRI scan, to get a detailed image of your foot.
Treating Morton's neuroma
- If you have Morton's neuroma, shoes with a wider toe area may be recommended.
- Sometimes special orthotic devices can help to take the pressure off the nerve.
- You can also take painkillers to help ease the pain.
- Steroid injections can also be given to the affected area to treat the inflamed nerve.
If these treatments don't work, surgery may be needed. If a surgical opinion is required, Dr Allfree will help you with the referral. Surgery is usually carried out under local anaesthetic, on an outpatient basis, which means you won't need to stay in hospital overnight. The operation can take up to 30 minutes. The surgeon makes a small incision, either on the top of your foot or on the sole. The space around the nerve is increased by removing some of the surrounding tissue, although sometimes the nerve has to be removed completely. If this is done the area between your toes will be permanently numb.