A neuroma is a thickening of nerve tissue that may develop in various parts of the body. The most common neuroma in the foot is a Morton?s neuroma, which occurs between the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma. ?Intermetatarsal? describes its location in the ball of the foot between the metatarsal bones. Neuromas may also occur in other locations in the foot. MortonThe thickening, or enlargement, of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates enlargement of the nerve, eventually leading to permanent nerve damage.
The exact cause of Morton's neuroma is not known. However, it is thought to develop as a result of long-standing (chronic) stress and irritation of a plantar digital nerve. There are a number of things that are thought to contribute to this. Some thickening (fibrosis) and swelling may then develop around a part of the nerve. This can look like a neuroma and can lead to compression of the nerve. Sometimes, other problems can contribute to the compression of the nerve. These include the growth of a fatty lump (called a lipoma) and also the formation of a fluid-filled sac that can form around a joint (a bursa). Also, inflammation in the joints in the foot next to one of the digital nerves can sometimes cause irritation of the nerve and lead to the symptoms of Morton's neuroma.
Outward signs of Morton's neuroma, such as a lump, are extremely rare. Morton's neuroma signs and symptoms, which usually occur unexpectedly and tend to worsen over time, include, pain on weight bearing (while walking) - a shooting pain affecting the contiguous halves of two toes, which may be felt after only a short time (of weight bearing). Sometimes there may be a dull pain rather than a sharp one. Most commonly, pain is felt between the third and fourth toes. Typically, a patient will suddenly experience pain while walking and will have to stop and remove their shoe. Burning. Numbness. Parasthesia, tingling, pricking, or numbness with no apparent long-term physical effect. Commonly known as pins-and-needles. A sensation that something is inside the ball of the foot.
A GP (general practitioner, primary care physician) or a podiatrist (foot specialist doctor) will ask the patient to describe the pain as well as its intensity, when symptoms started, what types of shoes are worn, as well as some questions about their job, lifestyle and hobbies. The doctor will then examine the foot and try to locate the affected nerve. This may involve attempting to reproduce symptoms by manipulating the foot. In order to get a detailed image of the inside of the food, one of the following scans may be ordered. X-ray, this is a type of high-energy radiation. In low doses they are used to diagnose diseases and condition by making pictures of the inside of the body. In higher doses they are used to treat cancer. This procedure is non-invasive and painless. Ultrasound scan, high frequency sound waves are pointed at a specific part of the body, which in this case is the foot. The ultrasound waves bounce of tissues; their echoes are then converted into a picture, called a sonogram. This allows the doctor to get an inside view of the foot. This procedure is non-invasive and painless. MRI (magnetic resonance imagining) a device that uses a magnetic field and radio waves to create detailed images of the body. Unlike CT scanning or general x-ray studies, no ionizing radiation is involved with an MRI. This procedure is non-invasive and painless. The doctor will have to rule out other conditions which may have similar symptoms, including capsulitis, bursitis, or Freiberg's disease.
Non Surgical Treatment
Orthotics and cortiغير مجاز مي باشدteroid injections are widely used conservative treatments for Morton?s neuroma. In addition to traditional orthotic arch supports, a small foam or fabric pad may be positioned under the space between the two affected metatarsals, immediately behind the bone ends. This pad helps to splay the metatarsal bones and create more space for the nerve so as to relieve pressure and irritation. It may however also elicit mild uncomfortable sensations of its own, such as the feeling of having an awkward object under one's foot. Cortiغير مجاز مي باشدteroid injections can relieve inflammation in some patients and help to end the symptoms. For some patients, however, the inflammation and pain recur after some weeks or months, and cortiغير مجاز مي باشدteroids can only be used a limited number of times because they cause progressive degeneration of ligamentous and tendinous tissues.
About one person in four will not require any surgery for Morton's neuroma and their symptoms can be controlled with footwear modification and steroid/local anaesthetic injections. Of those who choose to have surgery, about three out of four will have good results woke up with a foot pain (https://loreweelborg.wordpress.com) relief of their symptoms. Recurrent or persisting (chronic) symptoms can occur after surgery. Sometimes, decompression of the nerve may have been incomplete or the nerve may just remain 'irritable'. In those who have had cutting out (resection) of the nerve (neurectomy), a recurrent or 'stump' neuroma may develop in any nerve tissue that was left behind. This can sometimes be more painful than the original condition.
The best way to prevent a neuroma is by avoiding the things that cause them. Review your risk factors. If relatives have had similar problems, or if you know that you pronate or have any problem with the mechanics of your foot, talk with a podiatric physician about the correct types of shoes and/or orthoses for you. If you are not sure whether you have such a problem, the podiatric professional can analyze your foot, your stride and the wear pattern of your shoes, and give you an honest evaluation. Remember, though, that sometimes neuromas, like other conditions, can develop for no discernible reason. With this in mind, be good to your feet, and be aware of any changes or problems. Don?t wait to report them.
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