What is it?
Morton’s Neuroma is a swollen, inflamed nerve in the foot most commonly between the 3rd and 4th toes and under the ball of the foot. It is a benign tumour or can be described as fibrous tissue wrapping around the nerve.
It is a result of an entrapped nerve which becomes inflamed due to constant pressure on the nerve between the toes (metatarsals).
Symptoms of a Morton’s Neuroma:
A Morton’s neuroma causes a “burning” sharp sensation and numbness in the ball of the foot radiating into the toes.
What causes it?
Constant trauma from the surrounding bones damages the nerve. This is usually from poor foot biomechanics (pronating foot). The body will try and protect the nerve by increasing the thickness of the nerves insulating sheath.
- Poor footwear (shoes with little shock absorption or stability) can contribute to the development of a Morton’s neuroma.
- Poor foot biomechanics (Flat feet, bunions, retracted/hammer toes)
- High heeled shoes
- Athletes, especially toe runners, people who skip, and jumping type aerobics.
How is it diagnosed?
As Podiatrists we can usually diagnose a Morton’s neuroma on clinical history. We do not usually require diagnostic testing such as Ultrasound or MRI.
How is it treated?
Orthotics:
A neuroma should always be treated conservatively initially. This usually requires redistributing pressures away from the ball of the foot. This is most commonly done through orthotics with metatarsal domes. The orthotics realign the foot, increase stability and redistribute pressure away from the ball of the foot.
Change tight fitting footwear:
This causes lateral pressure on the bones, increasing the irritation on the nerve. High heeled court shoes and pointy toed shoes are the common culprits.
Anesthetic / Cortisone injection
This is done when the above treatments fail. The trauma is sometimes so great that conservative treatment cannot control the inflammation. An appropriate referral is arranged if this treatment is necessary.
Surgery
This is the last resort, where the neuroma is surgically cut out under anaesthetic. This can cause long term nerve damage (causing permanent numbness).
If you suffer from pain associated with Posterior Tibialis tendonitis, call Kew Foot Clinic on 03 9853 6877 to make an appointment for the appropriate treatment.
