Loz Berg

Foot Pain Diagnosis

Mortons Neuroma An Overview

Overview

intermetatarsal neuromaA neuroma is a painful condition, also referred to as a ?pinched nerve? or a nerve tumor. It is a benign growth of nerve tissue frequently found between the third and fourth toes. It brings on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot. The principal symptom associated with a neuroma is pain between the toes while walking. Those suffering from the condition often find relief by stopping their walk, taking off their shoe, and rubbing the affected area. At times, the patient will describe the pain as similar to having a stone in his or her shoe. The vast majority of people who develop neuromas are women.

Causes

Although in many areas of medicine, it?s easy to pinpoint the exact source of a problem (the way a specific germ causes a certain illness with recognizable symptoms), neuromas are harder to categorize. While there isn?t really one exact cause, podiatric physicians tend to agree that a neuroma can occur in response to the irritation of a nerve by one or more factors. Abnormality in foot function or foot mechanics: In other words, a foot that doesn?t move the way science thinks it should. In general, this means a pronated foot (one with an excessive rolling motion when the patient is walking, running or doing any kind of activity), because it causes excessive strain on the nerve. If you are not certain whether or not this is a problem for you, ask your podiatric physician, who will be able to examine your feet, as well as the wear pattern on your shoe, and give you an answer. Foot mechanics, and problems with them, tend to run in families, so if you know that a relative has had foot pain similar to yours, be sure to mention it.

Symptoms

If you have a Morton?s neuroma, you may have one or more of these symptoms where the nerve damage is occurring, Tingling, burning, or numbness, pain, a feeling that something is inside the ball of the foot or a feeling that there?s something in the shoe or a sock is bunched up. The progression of a Morton?s neuroma often follows the following pattern. The symptoms begin gradually. At first they occur only occasionally, when wearing narrow-toed shoes or performing certain aggravating activities. The symptoms may go away temporarily by removing the shoe, massaging the foot, or by avoiding aggravating shoes or activities. Over time the symptoms progressively worsen and may persist for several days or weeks. The symptoms become more intense as the neuroma enlarges and the temporary changes in the nerve become permanent.

Diagnosis

There is a special orthopedic test called the Morton's test that is often used to evaluate the likelihood of plantar nerve compression. For this test, the client is supine on the treatment table. The practitioner grasps the client's forefoot from both sides and applies moderate pressure, squeezing the metatarsal heads together. If this action reproduces the client's symptoms (primarily sharp, shooting pain into the toes, especially the third and fourth), Morton's neuroma may exist.

Non Surgical Treatment

Ice therapy and anti-inflammatory medications or supplements. If conservative care measures fail to resolve your problem, some foot care providers may recommend a cortisone injection around your involved nerve to help reduce your swelling and inflammation. Concentrated alcohol injections around your affected nerve have also shown good results and should be considered before undergoing neurectomy, a surgical procedure to remove the enlarged, traumatized portion of your involved nerve.Morton

Surgical Treatment

If pain persists with conservative care, surgery may be an appropriate option. The common digitial nerve is cut and the Mortons neuroma removed. This will result is numbness along the inside of the toes affected, and there is a small chance the end of the nerve will form a Stump Neuroma. Approximately 75% of people receive symptom resolution for Mortons Neuroma with conservative care.
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