Morton's neuroma is a pathological thickening of the plantar nerve in the foot. This condition is accompanied by pain in the area between the fourth and third fingers (rarely between the third and second).
Morton's neuroma in the medical literature may have other names: perineural fibrosis, Morton’s finger syndrome, Morton’s disease and others.
Women are more prone to the occurrence of an ailment. This is due to the frequent wearing of tight shoes with high heels, heavily loading the forefoot. In rare cases, Morton's neuroma affects both legs at once.
The most often called cause of the disease is excessive pressure on the metatarsal nerve . Such abnormal functioning can be triggered not only by the use of tight shoes in combination with overweight or high heels, but also by transverse flat feet.
Morton's neuroma at the beginning of development is characterized by numbness, burning or tingling between the fourth and third toes, aching pains. In tight shoes, sensations intensify. Sometimes patients complain of a feeling of the presence of a foreign body between the fingers.
Periodically, the manifestations of the disease may weaken or intensify. Acute pain is noted while walking. After removing tight shoes, it passes.
In the absence of timely treatment, soreness becomes constant. She can shift to her fingertips. In this case, the type of shoes does not matter much.
The longer perineural fibrosis develops without treatment, the more pronounced soreness between the fingers becomes.
The main diagnostic factor of the disease is the narrow localization of sensations between the fourth and third fingers. An important point in identifying the disease is the increase in pain in the transverse direction when the patient compresses the forefoot.
To clarify the diagnosis, an examination is necessary. Sometimes a specialist identifies areas of numbness manually. On examination, it is important to differentiate the diagnosis with other, similar in symptoms, diseases (arthritis, fracture). For this purpose, a radiograph may be used. In controversial or severe cases, MRI is used.
Preventive measures are aimed at reducing loads on the forefoot. This is mainly the choice of rational and optimal shoes and, of course, the prevention of transverse flat feet.
Morton's neuroma. Treatment
With the periodic nature of pain at the very beginning of the development of the disease, conservative therapy is very effective. This is due to the absence of irreversible disturbances in the nerves of the sole during this period. Patients are prescribed analgesics, corticosteroid injections, physiotherapeutic procedures. They also recommend choosing more comfortable shoes. Women have to give up high heels . All these measures contribute to unloading the foot and relieve pain, which is accompanied by Morton's neuroma. Treatment with folk remedies is ineffective.
If flat-footedness (transverse) is detected, the scheme of the therapeutic course will also include measures to eliminate it.
If there is no effect from the use of conservative methods of exposure, surgical intervention is prescribed. The operation is performed under local anesthesia. The metatarsal canal is opened and a neuroma is dissected. After the intervention, a small area of numbness between the fingers may remain. The recovery period, as a rule, is several months. Throughout the rehabilitation period, patients are advised to use rational shoes that do not exert pressure on the forefoot.