Brief Outline of Morton’s Neuroma
A neuroma is a tumour, growing from a nerve, or made up largely of nerve cells and nerve fibres. Morton’s Neuroma involves the plantar nerve, and is characterised by pain on the plantar side of the foot. When pressure is applied to the forefoot area, the bones may pinch the nerve causing pain, burning, or even loss of sensation to the affected area. Running (especially sprinting), walking, and jumping all place repetitive stress on this area and have the potential to cause Morton’s neuroma. Foot deformities, underlying foot abnormalities, tight-fitting shoes that compress the foot, can also lead to this condition.
Anatomy and Physiology of Morton’s Neuroma
The plantar nerve supplies the third and fourth toes, and runs between the metatarsl heads. When the bones are subjected to pressure due to tight-fitting shoes or a pronated foot, the plantar nerves become compressed between the metatarsal heads, which causes inflammation and swelling.
Cause of Morton’s Neuroma
Repetitive stress or trauma to the ball of the foot, such as with running, walking, or jumping. Pronation. Wearing footwear that compresses the foot. Injuries to the metatarsals of the third and fourth toe.
Signs and Symptoms of Morton’s Neuroma
Pain and/or burning sensation in the affected area. Possible loss of sensation in the third and fourth toes. Possible numbness, tingling, or cramping in the forefoot. While weight bearing in shoes, agonising pain on the lateral side of the foot may be present, which is relieved when going barefoot.
Complications If Left Morton’s Neuroma Unattended
If left unattended, a neuroma may lead to permanent nerve damage. Permanent loss of sensation to the toes may also result. Pain will increase without treatment, eventually leading to disability.
Immediate Treatment for Morton’s Neuroma
Anti-inflammatory medication, or injection. Rest and ice.
Long-term Prognosis for Morton’s Neuroma
When treated properly, a neuroma should recover completely without any long-term effects. The longer the injury goes untreated, the higher the possibility for lingering effects. Surgery may be required if the regular treatment does not lead to recovery.