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What Is The Difference Between Metatarsalgia And Morton'S Neuroma
Morton’s neuroma is a benign, or noncancerous, inflammation of nerve tissue that develops in the foot, usually between the third and fourth toes. It is a common and painful condition.This condition is also known as Morton’s metatarsalgia, Morton’s disease, Morton’s neuralgia, Morton metatarsalgia, Morton nerve entrapment, plantar neuroma, and intermetatarsal neuroma.It occurs due to a swollen nerve in the ball of the foot.Keep reading to learn more about the symptoms of Morton’s neuroma and the exercises, home remedies, and other treatments that can ease them. People with Morton’s neuroma may need to change their footwear, take pain relievers, or receive steroid injections. In some cases, surgery may be necessary to remove the affected nerve or release the pressure on it.The treatment options will depend on several factors, including:the severity of the symptomshow long they have been presentwhether a person has already tried at-home treatmentsThe earlier the person with Morton’s neuroma receives a diagnosis, the less likely they are to need surgery.If the symptoms are severe or persistent, and self-help measures prove ineffective, the doctor may recommend:Corticosteroid injections: A healthcare professional will inject a steroid medication that reduces inflammation directly into the area of the neuroma. A person should only receive a limited number of injections, as there may be side effects. These include pain, loss of fat at the injection site, skin discoloration, and elevated blood sugar.Alcohol sclerosing injections: Studies have shown that alcohol injections reduce the size of Morton’s neuromas, as well as alleviating pain. Morton’s neuroma surgeryIf other therapies have not worked and the symptoms persist, a doctor may recommend surgery. Surgery is usually effective, but it can result in permanent numbness in the affected toes. Due to this, doctors recommend trying other options first.Surgery involves removing either the nerve itself or the pressure on the nerve by cutting surrounding ligaments or fibrous tissue.Two surgical approaches are possible:Dorsal approach: The surgeon makes an incision on the top of the foot, allowing the person to walk soon after surgery because the stitches are not on the weight-bearing side of the foot.Plantar approach: The surgeon makes an incision on the sole of the foot. During recovery, most individuals will need to use crutches for 2–3 weeks. The resulting scar might make walking uncomfortable. However, the surgeon can easily reach and remove the neuroma without cutting any structures.There is a small risk of infection around the toes after surgery.To test for Morton’s neuroma, a foot specialist doctor called a podiatrist — or, in some cases, a sports medicine or orthopedic doctor — will examine the foot and manipulate it to try to locate the affected nerve. Doing this will reveal any symptoms. The doctor might also perform a maneuver to elicit a feeling of “clicking” between the toes, which is a sign of Morton’s neuroma.In addition, to get a detailed image of the inside of the foot, the doctor may order one of the following scans:X-ray: An X-ray can rule out other foot injuries, such as a stress fracture.MRI scans: This scan can detect Morton’s neuroma even when there are no symptoms, but it is a more expensive imaging test than the other options.Ultrasound scan: This scan is relatively cheap, requires no radiation, and can identify Morton’s neuroma with a similar accuracy to an MRI. It can also help distinguish Morton’s neuroma from other similar conditions, such as synovitis.These tests allow the doctor to rule out other conditions with similar symptoms, including capsulitis, bursitis, and Freiberg’s disease.In Morton’s neuroma, the tissue around one of the nerves leading to the toes thickens. People typically experience numbness and pain in the affected area, which it is possible to relieve by removing footwear and massaging the foot. The pain is usually stabbing or burning, but some individuals may experience dull pain instead.Share on PinterestMorton’s neuroma is caused by the thickening of the tissue around nerves and usually happens between the third and fourth toes. Here, the examiner is trying to assess the webspace tenderness that is seen in Morton’s neuroma by squeezing the foot.Gougoulias N, Lampridis V, Sakellariou A. Morton’s interdigital neuroma: instructional review. EFORT Open Rev. 2019;4(1):14-24. Published 2019 Jan 23. doi:10.1302/2058-5241.4.180025Most people feel pain when the foot bears weight, although it may only occur after a short time of walking. They may have to stop and remove their shoe at this point. A shooting pain may affect the adjacent sides of the third and fourth toes. These symptoms usually occur unexpectedly and tend to worsen over time.Visible signs of Morton’s neuroma, such as a lump, are extremely rare. Instead, the most common symptoms include:burning pain, which people often describe as resembling a “red hot needle” and which can start suddenly while walkingnumbness, which may affect the toesparesthesia, which is a tingling, pricking, or numb feeling with no apparent long-term physical effect, commonly known as pins and needlesa sensation of something being inside the ball of the footMany people with Morton’s neuroma describe the sensation as a burning pain in the ball of the foot that often radiates to the toes.Initially, the pain might become much more apparent when the person wears tight, narrow, or high-heeled shoes or engages in activities that place pressure on the foot. The symptoms may be continuous and last for days or even weeks.They can become so severe that affected individuals become anxious about walking or even placing their foot on the ground. In some cases, however, the neuroma is symptomless. MRI scans sometimes reveal Morton’s neuroma lesions in people who have no symptoms at all.Share on PinterestThe examiner is squeezing the web space between the toes with their thumb and finger to see if there is tenderness. Morton’s neuroma will often cause tenderness in this area.Santiago FR, Muñoz PT, Pryest P, Martínez AM, Olleta NP. Role of imaging methods in diagnosis and treatment of Morton’s neuroma. World J Radiol. 2018;10(9):91-99. doi:10.4329/wjr.v10.i9.91Share on PinterestPost-surgical wrapping after surgery to help with pain from Morton’s neuroma. This surgery usually needs a short recovery period.LagunaticPhoto/Getty ImagesMorton’s neuroma responds well to rest, but if the pain levels allow, some stretching and strengthening exercises may help maintain and improve strength in the arch of the foot. Examples include exercises that stretch the lower leg and calf muscles and those that stretch the Achilles tendon and the plantar fascia along the bottom of the foot.It is important to start exercising the foot slowly to stop the nerve from becoming inflamed again.Some simple exercises include:Plantar fascia stretch: Put a towel on the floor and place the foot on the closest edge. Use the toes to scrunch the towel in a way that brings the far edge of the towel closer. Adding a weight to the towel makes this exercise more challenging.Big toe stretch: Sit on the floor and wrap an exercise band around the big toe. Extend the leg and use the band to pull the foot back gently. Then, use the big toe to push the foot forward. Repeat three times.Ball roll: Place a golf ball or similarly sized ball under the foot and roll it for 1 minute.Research shows that following a combined physical therapy approach that includes exercises, massage, mobilization of the affected joint, and education on pain management may produce the best results. Alongside performing exercises, self-help measures for Morton’s neuroma include:resting the footmassaging the foot and affected toesapplying a cloth-wrapped ice pack to the affected areausing arch supports — a type of padding that supports the arch of the foot and removes pressure from the nervewearing broad-toed shoes to allow the toes to spread out and reduce frictiontaking over-the-counter (OTC) pain relieversmodifying activities — for example, avoiding or taking a break from activities that put repetitive pressure on the neuroma — until the condition improvesreaching a moderate weight, if necessary, as this can improve symptoms in people with excess weightSeveral types of orthotic devices or arch-supporting shoes, metatarsal pads, or bars are available OTC. People can place these under the neuroma. Taking measures to reduce the pressure will help reduce the level of pain.Experts are not sure exactly what causes Morton’s neuroma. It seems to develop when the tissues thicken, compressing and inflaming one of the nerves that lead to the toes. This triggers a response, resulting in thickened nerve tissue.A high percentage of those with Morton’s neuroma wear high-heeled or narrow shoes.Conditions and situations that can cause the bones to rub against a nerve include:high-heeled shoesshoes that are too narrowshoes with a pointed or tight toe box that squashes the toes togetherhigh-arched feetdeviation of the toesflat feet, in which the entire sole comes into contact with the grounda bunion, which is a localized painful swelling at the base of the big toe that enlarges the jointhammer toe, which is a deformity within a joint of the second, third, or fourth toe that causes it to become permanently bentsome high impact sporting activities, including running, soccer, tennis, karate, and basketballinjury or trauma to the footMorton’s neuroma is at least five times more common in females than in males.Morton’s neuroma is a growth on the foot that is usually benign. It typically develops between the third and fourth toes as a result of a swollen nerve.The condition can be painful, but various home remedies and medical treatments can help alleviate discomfort. If none of these are successful, surgery can be an option.
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