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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 3rd and 4th toes, counting from the big toe. The patient will complain of pain in the sole of the foot.

Symptoms of Neuroma

  • Begins with numbness or tenderness in the foot, just behind the 3rd and 4th 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 areas of the foot.
  • The patient may experience spontaneous shooting pains, which is often referred to as an "electric shock". This can affect patients when they are sleeping at night.

 

Neuroma

Causes of 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 overpronation. Overpronation 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 overpronates the structures of the foot are put under stress, which increases the likelihood of a neuroma occurring. The Dr Foot Gel Plus insoles supports the forefoot and arch which prevents the metatarsals from dropping. As a result, this helps reduce the squeezing of the nerve and consequent tingling and pain associated with Morton's Neuroma.

Treatment for Neuroma

  • Firstly, the podiatrist will diagnose the condition. History of the condition, clinical presentation and your description of the problem may be sufficient.
  • The podiatrist 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. This may rule out a stress fracture of the foot.
  • You may be referred for a MRI scan, which will enable the chiropodist to see the neuroma.
  • Various types of metatarsal pads can be used to redistribute pressure away from the lesion. View some examples here
  • Orthotics (insoles) may be prescribed to redistribute pressure away from the neuroma.
  • The podiatrist may advise your General Practitioner to inject inflammatory medicine into the neuroma.
  • Appropriate shoes may be recommended. One of the first changes made by many women patients is to stop using high heeled shoes, as this puts additional forces and pressure on the metatarsal area and escalates the pain.
  • In severe cases, surgery may be necessary. Removal of part of the nerve may be performed.

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