Neuroma / Morton's Neuroma

Nerves provide sensation and give the signal to the muscles to move.

Morton's neuroma is a thickening of tissues around the nerve that leads to the toes, caused by tissue rubbing against and irritating the nerves.

Morton's neuroma usually develops between the third and fourth toes in response to an abnormal bone structure, unstable forefoot or due to pressure from tight fitting shoes - wearing high-heeled or narrow shoes or trauma.

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Causes:

1. Tight ligamentous structures that directly compress the nerve.
2. Pronated or flatfeet.
3. Nerves may become irritated from tight shoes or sports that put stress on the ball of the foot.
4. Arthritis or bone spurs from the adjacent joints.
5. Soft tissue cysts causing nerve compression.
6. Trauma to the ball of the foot.

Symptoms:.

1. Pain on the ball of the foot with weightbearing.
2. Numbness, burning, shooting, pain, or tingling sensation in the ball of the foot which often radiates to the toe region. Some or all these symptoms may be present.
3. A feeling that there is a ball in the bottom of the foot or crumpled up sock in the bottom of the foot when wearing footwear.
4. Cramping in the toes.
5. Pain, numbness, burning, shooting, pain, or tingling sensation that is aggravated by tight shoes, high heels or walking barefooted.
6. Activities such as running, cycling, aerobics or high impact activities that put stress on the ball of the foot may aggravate this condition.

Treatment:
The goal of treating this condition is to reduce the inflammation around the nerve and to prevent further trauma to it.

1. Changing into shoes without a heel and are wide in the front of the shoe.
2. Changing activities temporarily to non-weightbearing/ less impact exercises such as biking and swimming.
3. Anti-inflammatory pills.
4. Physical therapy may be helpful to reduce the inflammation.
5. Metatarsal pads.
6. Custom molded orthotics to correct faulty biomechanical problem. Orthotics support the forefoot and arch which prevents the metatarsals from dropping.
7. Cortisone injections around the nerve to decrease the inflammation and scar tissue.
8. Injecting the nerve with a solution containing a small degree of alcohol and an anesthetic. This may cause the nerve to shrink up and cease the nerve from functioning.
9. When all else fails surgical removal of the nerve may be necessary.

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