Morton's Neuroma

What is a Neuroma?

A neuroma can occur in various parts of the body and is characterised by the thickening of nerve tissue. The most common neuroma of the foot is Morton's neuroma and occurs between the 3rd and 4rd metatarsal bones. Because it occurs between the metatarsal bones it is sometimes referred to as a intermetatarsal neuroma. The nerve thickens as a result of irritation and compression and can lead to permanent nerve damage. 

Causes

There are many causes of neuromas, including:

  • Small/Tight Shoes - especially shoes that taper towards the toes, causing compression on the foot.

  • Foot Deformities - it is common for people suffering from foot problems such as bunions, flatfeet or hammertoes to develop neuromas. 

  • Sports/Activities - activities with repetitive motions, such as running, tennis or soccer.   

  • Trauma - neuromas can result from trauma.

Treatments

For mild to moderate neuromas, treatment options may include:

  • Padding - used to support the metatarsal arch, which lessens the pressures on the nerve and decreases compression while walking.

  • Ice - Placing an icepack on the affected area helps reduce swelling. An ice pack can be wrapped in a towel and applied to the area (never apply ice directly to the skin) for periods of no greater than 20 minutes. 

  • Orthotic Inserts - Custom orthotics provide more support, which helps to reduce pressure and compression on the nerve.

  • Activity Changes - a change to fewer activities that irritate the neuroma, such as standing or walking for long periods of time, is recommended.

  • Shoe Change - Wearing shoes with a wider toe box and avoiding narrow-toed shoes.

  • Injection therapy - corticosteroid injections are sometimes used to ease pain and inflammation. 

  • Oral Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.

If these treatments prove ineffective or if the neuroma is in an advanced stage then surgical intervention may be recommended. 

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