Morton’s Neuroma (Foot)

In medical terminology, the toes are referred to as digits and are numbered from one to five, with the big toe being the first digit and the little toe the fifth. Nerves extend from the foot to the toes, facilitating movement and sensation.

Morton’s Neuroma commonly develops between the third and fourth digits, where two nerves converge and thicken. A ligament, known as the deep transverse metatarsal ligament, encases the nerves and holds the bones together. Symptoms arise when the nerve is compressed between this ligament and the bottom of the foot.

The precise cause of Morton’s Neuroma remains unclear. It occurs when the tissue surrounding the nerve between the third and fourth toes thickens and swells, resulting in nerve compression and inflammation.

Individuals with bunions, flat feet, or hammertoes are more prone to this condition. Activities involving prolonged standing, walking, jumping, or running, as well as wearing tight-fitting, high-heeled, or pointed shoes, can contribute to the development of Morton’s Neuroma. High-impact sports like racquetball, squash, or tennis may also increase the risk.

Symptoms of Morton’s Neuroma include sharp pain, tingling, numbness, stinging, and burning sensations between the third and fourth toes, as well as in the ball of the foot. Patients often describe a sensation of having a lump in the ball of the foot or feeling as though they have stepped on a bump. Symptoms may worsen with weight-bearing activities and typically begin gradually, fluctuating in intensity before worsening over time.

If you experience symptoms indicative of Morton’s Neuroma, it’s important to consult a healthcare provider. Early intervention can help prevent the need for surgery. Diagnosis involves a review of your medical history, a physical examination of the foot, and potentially X-rays.

During the examination, your doctor will assess for any noticeable bumps or masses and identify the source of your symptoms. X-rays may be employed to exclude other conditions like fractures or arthritis, while an MRI may be recommended for further evaluation of the neuroma’s size and location.

Several treatment options exist for mild to moderate cases of Morton’s Neuroma, with the choice of treatment based on symptom severity. Resting, wearing suitable footwear, and using over-the-counter pain relievers such as ibuprofen can alleviate swelling and pain. Foot padding or orthotics may also help distribute pressure more evenly.

If conservative methods fail, your doctor might suggest corticosteroid injections to reduce pain and inflammation. Alcohol sclerosing injections may also be used to harden the nerve area and provide pain relief.

Surgery may be considered when other treatments do not effectively alleviate symptoms. The two primary surgical options for Morton’s Neuroma are release surgery and removal surgery.

Release surgery entails making an incision on the top of the foot to access the deep transverse metatarsal ligament, allowing for decompression of the nerve. Removal surgery is conducted via an incision on the bottom of the foot, facilitating direct access to the neuroma for its surgical removal, after which the incision is stitched closed.

Recovery duration varies depending on the type of surgery performed. In cases of release surgery, since there are no stitches on the bottom of the foot, patients may resume walking shortly after the procedure. Conversely, removal surgery typically requires crutches post-operatively due to stitches on the foot’s underside. Regardless of the treatment type, the healing process is unique to each individual, and your physician will guide you on what to expect.