How often, when taking off narrow, uncomfortable shoes, do you notice that the foot hurts? The pain between the third and fourth fingers is especially severe. Maybe you are just tired for a day, or maybe you have a Morton neuroma. Symptoms of this disease do not appear immediately, but you need to know about them.
What it is?
The problem has several names: Morton’s syndrome, Morton’s neuroma, Morton’s disease, Morton’s metatarsalgia, perineural fibrosis, Morton’s finger. This is a benign thickening of the foot, consisting of fibrous tissue. There is a thickening on the plantar nerve of the foot. In most cases, the pathology is one-sided, although it occasionally develops on both feet. Most often, Morton's syndrome occurs in women, as they wear narrow shoes with uncomfortable heels. But men are prone to this disease.
Causes of Perineural Morton Fibrosis
The following causes provoke the development of the disease:
- Overweight. The reason is one of the most common in this disease. The legs experience a lot of stress, as a result of which the proliferation of fibrous tissue of the plantar nerve begins.
- Frequent wearing high heels. The load on the feet increases, which provokes an inflammatory process in the area of the plantar nerve.
- Wrong selection of shoes in size and volume. Prolonged squeezing of the foot in tight shoes injures nerve fibers.
- Received injuries (fractures, bruises, hematomas) along the nerve and chronic diseases.
- Cross flatfoot.
- Obliterating atherosclerosis of the legs, causing blockage of the vessels of the legs with cholesterol plaques.
- Tumors
- Physical exercise.
Symptoms of the disease
If you suspect that you have a Morton neuroma, symptoms will appear depending on the neglect of the disease. This process depends on the degree of nerve irritation by nearby tissues. For a long time, the foot does not feel discomfort during walking, but when squeezing the interdigital area, slight pain appears. As the fibrous tissue grows, the heads of the metatarsal bones are pressed on the nerve from two sides, and edematous tissues and hematoma exacerbate this effect. The first complaint is most often associated with numbness of the foot and discomfort during a long walk. Morton's disease brings especially painful sensations to those who prefer high-heeled shoes, as the pressure on the neuroma zone increases.
Another symptom is burning in the tissues of the foot and fingers. Noticeably at the same time an internal tingling is attached. There is a sensation of a foreign object in the tarsal space. Exacerbations roll in waves: the rest period alternates with intense pain.
Morton's syndrome prevents long legs. The pain becomes very strong, but if you remove the shoes and massage the feet, then it decreases or completely disappears.
Further development of the disease increases the intensity of the pain. It acquires a pulsating character, and the intervals between attacks are significantly reduced. The lack of treatment leads to Morton's disease causing constant pain, which no longer depends on the quality of the shoes and the duration of the walks. Neither massage, nor complete rest of pain sensations are removed.
One of the features of the disease is that the patient's symptoms may disappear completely and not be repeated for several years. But the disease does not go away, but as if freezes. It is impossible to predict at what point it will appear. In addition, it should be noted that external manifestations on the foot with this neuroma are not noticeable.
Pathology diagnostics
A legitimate question for a patient with Morton syndrome is which doctor treats this disease. With the symptoms of this disease, you can contact a neurologist, surgeon or orthopedist. First of all, doctors conduct a survey of the patient and examination of the problematic foot. Sometimes this is enough to make a diagnosis.
To clarify, the specialist can refer the patient to an X-ray, MRI or ultrasound. These examinations allow you to determine the exact location of the neuroma and indicate its size.
Treatment methods
If the disease is not very neglected, then the patient has a choice of how Morton's neuroma will be treated: treatment at home (conservative) or surgery. However, a decision must be made based on the opinion of a specialist. As you know, each treatment method has its pros and cons.
Conservative method
If the patient does not agree that surgery is necessary, then the doctor will choose a conservative method of treatment:
- To reduce the load on the foot, it will be recommended to walk less and not stand for long in one place.
- To prevent squeezing, the patient will have to reconsider their preferences in shoes. Shoes and boots should be low-heeled, and with wide toes.
- Orthopedic insoles with inserts must be inserted into the shoes. In certain cases, Morton's syndrome requires the wearing of finger separators.
- It is necessary to perform daily foot massage from the ankles to the tips of the fingers.
- The doctor prescribes the use of non-steroidal anti-inflammatory drugs (tablets or ointments). It can be Ibuprofen, Nimesulit, Diclofenac.
- If necessary, corticosteroids are prescribed.
Subject to these recommendations, Morton's syndrome, the treatment of which was carried out at home, should decrease in 3 months. If the pain does not lose intensity, then painkillers are additionally prescribed.
Pros and cons of the conservative method
The main plus of this treatment method is the absence of postoperative pain and a long rehabilitation period. Conservative treatment can be carried out without a sick leave. The patient lives in the usual rhythm, just adds a few mandatory points to the daily routine.
The disadvantage of this method is the duration of the course (as already mentioned, with a diagnosis of Morton's neuroma, treatment at home can last up to three months). Often, patients simply do not have the patience to complete the course to the end. In addition, the prescribed drugs can give side effects and affect the functioning of other organs and systems. In addition, the method does not always help.
Surgical treatment
An operative type of treatment is offered to patients at a late stage of neuroma or in the absence of conservative therapy results. The operation can be carried out in several ways:
- Removal of the neoplasm through an incision. This is the simplest operation that eliminates Morton's syndrome. Fibrous tissue is removed along with a small area of the nerve. Postoperative sutures are removed on the fourteenth day. Such an intervention is considered minimally invasive. The next day, the patient is allowed to carefully load the leg.
- Occasionally, the patient is required to excise the inflamed part of the foot. This radical method leads to a loss of finger sensitivity, while pain is not felt in the future.
- In rare cases, the method of artificial bone fracture is used. Rehabilitation after such an intervention is delayed for a month or more.
Pros and cons of surgery
The main advantage is the complete elimination of the problem in a short time. Conducting a simple operation is financially less expensive than a long medical course.
The disadvantage of surgical treatment is a long rehabilitation. In addition, slight walking discomfort may later be felt.
Morton's syndrome: treatment with folk remedies
It is very important to understand that with Morton's neuroma, traditional medicine is not able to eliminate the problem. However, it alleviates the condition and reduces pain.
Traditional healers offer several prescriptions that are used in combination with medical prescriptions:
- Lotions of bitter wormwood. The plant is rinsed and rubbed into the pulp, which is applied to the inflamed area of the foot and is fixed with a bandage. It is most convenient to perform before bedtime and keep the lotion until the morning.
- Salted pork or goose fat. A tablespoon of salt is mixed in one hundred grams of pork or goose fat. The mass is carefully rubbed into a sore spot, a warming dressing is applied on top.
- "Hot" grinding. This warming agent consists of two tablespoons of dry mustard, two hot peppers and two tablespoons of salt. All this is mixed and insisted on a glass of vodka. Rubbing improves blood circulation and warms the foot well. The procedure is performed before bedtime, after which they put on warm socks.
- Ointment from bay leaves and pine needles. Dry bay leaf grind in a coffee grinder. Pine needles are crushed with a knife. Next, 2 tablespoons of the first ingredient and 1 tablespoon of the second are mixed with softened butter. Feet are lubricated and insulated. The procedure is performed before bedtime, the minimum course is 1 week. The product is stored in a cold place.
Additionally, you can make warm baths with chamomile, lavender or calendula, to which add sea moth. The temperature of the bath should not exceed 38 ° C. The herbs are boiled for 3-5 minutes before use and insisted for about an hour.
And again about the insoles
The choice of high-quality comfortable shoes with a good orthopedic insole can prevent overload of the forefoot and prevent the development of the disease. Any doctor will confirm that orthopedic insoles with Morton's neuroma become an important element of treatment. The ideal option is to make individual insoles according to the patient’s feet. Thus, the foot in the shoe is fixed in the correct position, the load is distributed and a shock-absorbing effect is created. Wearing individual insoles is recommended not only with conservative treatment, but also after surgery to eliminate Morton's disease.