NEUROMA

(MORTONS NEUROMA)

INTRODUCTION TO NEUROMA

The term neuroma refers to a swelling of a nerve. The nerve commonly affected is a small nerve that connects the 3^rd and 4^th toes, counting from the big toe. The patient will complain of pain in the sole of the foot.

 

SYMPTOMS OF A NEUROMA

• Begins with numbness or tenderness in the foot, just behind the 3^rd and 4^th toes
• At a later stage, pain, numbness, burning and tingling sensations can radiate around the foot.
• The symptoms may appear and disappear spontaneously.
• Severe pain may be present at weight bearing.
• The patient may experience spontaneous shooting pains, which is often referred to as an "electric shock". This can affect patients when are sleeping at night.

 

CAUSES OF A NEUROMA

• The pulling of the ligaments under the foot irritates the nerve.
• High heels can damage the nerve.
• A tight toe box will squeeze the toes in the foot and therefore put pressure on the nerve.
• Mechanical problems with the feet such as "over pronation". Over pronation can be simply described as a condition, which causes your arches to flatten out when you stand up. This causes your ankles to roll in towards each other and disturbs your normal walking pattern. If a foot over pronates the structures of the foot are put under stress, which increases the likelihood of a neuroma occurring.

 

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TREATMENT

• Firstly, the chiropodist will diagnose the condition. History of the condition, clinical presentation and your description of the problem may be sufficient.
• The chiropodist may squeeze the area between the bases of the toes. The area may be sensitive and an audible click may be present. This click is the neuroma pushing between the bones and is often referred to as a mulders click.
• X-rays may be necessary of the foot. This may rule out a stress fracture of the foot.
• You may be referred for a MRI scan, this will enable the chiropodist to see the neuroma.
• Various types of pads can be used to redistribute pressure away from the lesion.
• Orthotics (insoles) may be prescribed to redistribute pressure away from the neuroma.
• The chiropodist may advise your General Practitioner to inject inflammatory medicine into the neuroma.
• Appropriate shoes may be recommended.
• A decrease in symptoms may occur instantaneously, with a complete recovery in a few months. However, the patient may need to use insoles to prevent a further reoccurrence.
• In severe cases, surgery may be necessary. Removal of part of the nerve may be preformed.