Morton's Neuroma

Every year tens of thousands of Americans will be diagnosed as having Morton’s Neuroma. In all likelihood, this represents 1/10th of the actual cases since misdiagnosis, lack of medical treatment and non-reported cases are so common.

What Is a Neuroma?

Laymen often use a variety of descriptions such as neuroma, toe neuroma or Morton neuroma foot. However, the condition we know as Morton’s Neuroma takes part of it’s true name from the doctor who first described it a little over 100 years ago, Thomas Morton. The term neuroma, literally means, “nerve growth.” The Morton’s Neuroma is basically a benign but painful thickening of the nerve located just behind adjacent toes (usually, but not exclusively, the third and fourth toes). Overtime, this thickening becomes a hard mass making the nerve useless and vulnerable to continued trauma and pain.

Neuroma Symptoms …

The pain from neuromas may start gradually causing burning, tingling, cramping, or numbness. Symptoms often occur after walking or standing for a period of time. Initially this is mistaken as “foot fatigue” and not taken seriously. However, if you have to stop walking, standing, or stooping on a regular basis and feel the need to massage the painful area then you may be experiencing signs of a neuroma in development. Later, as the nerve mass grows due to continued trauma, the pain becomes persistent even when shoes are not worn. In some cases, the pain radiates from the top of the toes to the ankle.

Neuroma Causes?
A neuroma can occur anywhere there is chronic irritation to the nerve sheath. Growth in the Morton’s Neuroma is caused by irritation that results when two bones in the foot repeatedly rub together and pinch the sensory nerve in between them. Cause of this abnormal nerve growth is probably protective in nature initially but destructive later. Clearly women are affected more often than men; this may be due to narrow shoe styles and heels. Nerve problems due to diabetes or alcohol abuse may create neuroma-like symptoms.

Early Treatment Is Needed
Treatment is aimed at reducing the inflammation surrounding the nerve. This may take the form of anti-inflammatory medications such as ibuprofen, changing to roomier footwear, using neuroma pads, specially designed, orthotics, and the judicious use of injection therapy. Our experience is that 60% of the cases resolve if the neuroma is diagnosed and treated within six months after the first symptoms appear. Following the “six month window” the success rate diminishes due to scarring and other irreversible changes that take place in and around the nerve. In these cases, to relieve pain, the damaged section of nerve is removed. This results in the elimination of pain. There is a slight loss of sensation between the affected toes, however, patients invariably report that this is preferable to the intense pain prior to removal. With an experienced surgeon approximately 80% of the patients are satisfied with the final treatment. In most cases, walking is allowed immediately afterwards. So listen to your feet. They may be trying to tell you something.

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