Have you ever experienced tingling, numbness, and sharp-shooting pain between your toes? Dont be surprised, but you may have Mortons neuroma. Mortons neuroma is a benign, reactive lesion of a nerve trunk that develops as a result of excessive stress to the ball of the foot and the toes. Basically, nerves become entrapped and produce inflammation, which is very painful. The most common location for the development of this painful condition is between the 3rd and the 4th toes. However, it is not unusual to have this condition between the other toes.
There are certain populations of patients that develop neuroma. Among these people are
Women wearing high heel, narrow, pointed shoes, or ill fitted shoes.
Athletes who engage in certain sport activities that cause excessive amount of stress to the ball of the foot and the toes.
The pain is mostly felt beneath the ball of the foot and aggravated by shoe gear and ambulation. Some patients describe the pain as a sharp pain that radiates either toward the toes or shooting up to the ankle. Once neuroma reaches its advanced stage, the palpable soft tissue mass causes pain and discomfort described by patients like having a pebble inside their shoes.
The podiatric physician can feel and locate the Mortons neuroma by simple clinical diagnosis. Basically the clinician applies a side-to-side pressure to the affected foot, which causes the neuroma to move and be felt between the examiners fingers. As a safety measure an x-ray is always taken to rule out any bony pathology. Once the neuroma is diagnosed, the treatment options will be discussed with the patient.
To start the treatment conservatively the following options are available to the patients orthotic devices, proper shoe gear and injection therapy.
Proper shoe gear
Adding more cushion and support to either the athletic shoe or dress shoe.
In some cases when conserva-
tive treatment fails to provide the needed relief, surgical intervention is necessary to remove the neuroma. However, injection therapies have provided a great amount of relief and orthotic devices have helped to some extent.
Early detection and proper management of neuroma help to reduce the discomfort and pain.