Do you experience a sensation of burning and/or tingling at the tips of your toes? Is this pain frequently relieved by removing your shoes or massaging your feet?
These are a few of the symptoms described by those suffering from a common foot condition known as a Morton's Neuroma. Although generally a benign condition, a neuroma can be quite annoying and cause extensive discomfort. A Morton's Neuroma is an irritated, thickening of the nerve in the ball of the foot, usually described as a pain located between the base of the third and fourth toes. The involved nerve is sometimes squeezed and irritated by these adjacent metatarsal heads located in the ball of the foot, causing the painful neuroma to develop. This area is already subjected to considerable pressures from shoes and walking. We now know from experience that a neuroma can also develop between the second and third metatarsals. In fact, a neuroma can develop anywhere there is a nerve. Neuromas are more commonly a problem for women. High-heeled shoes with cramped pointed tips cause additional pressure and irritation on the nerves in the ball of the foot. Individual complaints and symptoms for a neuroma vary. Frequently, a burning sensation is experienced in the ball of the foot. Patients also complain of cramping in the foot. A sharp pain is sometimes experienced between the bones (metatarsal heads) at the base of the toes. This pain, and sometimes a feeling of numbness or burning, may involve the corresponding toes that the nerve supplies. Of course, walking in shoes aggravates pain. Often patients say there is relief after removing their shoes and perhaps massaging their foot. Less commonly, patients describe a sensation of pressure such as "walking on a pebble" because the inflamed, swollen nerve is felt under the ball of the foot. A neuroma may be the result of an injury or from wearing the wrong shoes. Most of the time, patients have no recollection of any injury. A diagnosis of neuroma is based on the symptoms described by the patient and a good clinical exam. A clinical exam will rule out other disorders, which may be present with similar symptoms. A neuroma is a non-cancer growth in the foot. Stress fractures, metatarsalgia, rheumatoid arthritis, diabetic neuropathy and referred pain from the back are just a few conditions which cause foot pain.
Treatment begins with conservative padding and strapping of the foot. Orthotic devices are very effective for treating this problem. Either the rigid (graphite fiber devices) or the sports orthotics are effective for the treatment of a neuroma. Sometimes a metatarsal pad needs to be incorporated into the orthotic. Other treatments include anti-inflammatory drugs, physical therapy, steroid injections and the changing of shoe types. Although early diagnosis and treatment of the problem will increase the success of conservative care, surgical excision of the involved nerve mass provides the best relief from this painful condition, particularly in chronic cases. In such cases our doctors employ precise surgical techniques to identify and remove the offending benign (non-cancerous) tumor. It is important that proper dissection is used to prevent reoccurrence and/or prolonged recovery.
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