Morton”s Neuroma

A neuroma is a benign growth of nerve tissue that can develop in various parts of you body.

The most common location of a neuroma in the foot is between the third and fourth metatarsal interspace.  The condition is actually a thickening of fibrous tissue around one of the nerves which causes it to get pinched between the metatarsal bones. This causes a sharp, burning pain in the ball of the foot which often radiates to the sides of the toes. It is often described as an ‘electric shock’ radiating to the end of the toe.

The cause of a neuroma is not fully understood. It is generally dscribed as trauma to the nerve which causes an inflamatory reaction and thickening round the nerve. Once this thickening becomes large enough,, the nerve then gets pinched within the corresponding metatarsal heads.  This often will occur in patients that wear thin soled shoes or high heels as well as those invovled in high impact athletic activities.

The diagnosis of a Morton’s neuroma is made by the clinical description of the problem as well as pain with palpation to the interspace as well as a ‘clicking’ (Mulders sign) of the nerve as it gets caught between the metatarsal heads when the front of the foot is manually compressed.

Treatment of Morton’s neuroma is dependent upon the severityof the symptoms. The most conservative treatment includes wearing wider, softer shoe gear as well as reducing inflamation with ice and anti-inflamatory medication.  If the pain is more severe, a corticosteroid injection may be necessary.  When conservative treatment is not effective, the nerve can be sclerosed with a series of concentrated alcohol injections or a portion of the nerve may be removed surgically, effectively eliminatiing the problem.  This procedure is highly successful in eliminating the painful symptms of the neuroma, however it may result in some permanent nubness between the affected toes.

For more information contact:

Dr. William A Sachs


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