05 juin 2017 ~ 0 Commentaire

What Causes Mortons Neuroma

Overview

intermetatarsal neuromaPut simply – Morton’s neuroma is a swollen (inflamed) nerve in the ball of the foot, commonly between the base of the second and third toes. Patients experience numbness and pain in the affected area, which is relieved by removing footwear and/or massaging the foot. A neuroma is a tumor that arises in nerve cells, a benign growth of nerve tissue that can develop in various parts of the body. In Morton’s neuroma the tissue around one of the nerves leading to the toes thickens, causing a sharp, burning pain in the ball of the foot. A sharp severe pain, often described as a red hot needle may come on suddenly while walking. There may also be numbness, burning and stinging in the toes. Although it is labeled a neuroma, many say it is not a true tumor, but rather a perineural fibroma (fibrous tissue formation around nerve tissue).

Causes

Morton’s neuroma may be the result of irritation, pressure or injury. In some cases its cause is unknown. In the majority of cases only one nerve is affected. Having both feet affected is extremely rare. A high percentage of patients with Morton’s neuroma are women who wear high-heeled or narrow shoes. Patients with Morton’s neuroma may need to change their footwear, take painkillers or steroid injections, while others may require surgery to either remove the affected nerve or release the pressure on it.

Symptoms

The symptoms of a Morton’s neuroma are classic in nature. The patient complains of a burning , tingling, slightly numb feeling (dysesthesias) which radiates out to the toes on either side of the interspace that is involved. For instance, a Morton’s neuroma of the third interspace will result in pain between the third and fourth toes, and a neuroma in the second interspace will cause pain between the second and third toes. The symptoms are usually aggravated by wearing shoes, particularly those with high heels. Symptoms are relieved by walking in flat, wide shoes or going barefoot. Rarely will the patient experience pain when sitting or laying down.

Diagnosis

A doctor can usually identify Morton’s neuroma during a physical exam. He or she will squeeze or press on the bottom of your foot or squeeze your toes together to see if it hurts. Your doctor may also order an X-ray of your foot to make sure nothing else is causing the pain.

Non Surgical Treatment

Anti-inflammatory drugs may be recommended to dull the pain and lessen swelling. Neuropathic pain medications such as the antionvulsants and / or antidepressants may be tried as well. Many are able to recover from this issue at home by icing the area, resting the feet, and by avoiding wearing narrow or tight shoes. If these remedies do not work to alleviate symptoms, the doctor may give special devices to separate the toes and avoid the squeezing of the nerve. Steroid injections may reduce pain and swelling. Surgery may be required if these do not help.What Causes Mortons Neuroma 120913-post-operacic3b3n

Surgical Treatment

When conservative measures are unsuccessful, surgery can be a good choice in the treatment of Morton’s neuroma. The operation for Morton’s neuroma does not require an overnight hospital stay. The anesthetic used is an ankle block, which completely numbs the foot during the surgery. The physician removes the neuroma from an incision made on the top of the foot between the involved metatarsal heads. The nerve to the interspace is exposed and cut next to the metatarsal heads.

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