Morton’s neuroma is a common and often painful foot condition that affects the nerves between the toes. It is characterized by a thickening of the tissue surrounding one of the nerves leading to the toes, most frequently between the third and fourth toes.
This thickening can cause sharp, burning pain, numbness, or a sensation of a pebble in the shoe, significantly impacting daily activities and quality of life. Understanding Morton’s neuroma is important because early diagnosis and appropriate treatment can relieve symptoms and prevent progression, allowing individuals to maintain an active lifestyle.
To appreciate Morton’s neuroma, it is essential to understand the anatomy of the foot, particularly the nerves involved. The foot contains several digital nerves that run between the metatarsal bones (the long bones in the midfoot) and provide sensation to the toes. The most commonly affected nerve in Morton’s neuroma is the plantar digital nerve located between the third and fourth metatarsal heads.
The nerve passes through a narrow space bordered by ligaments and bones, making it susceptible to compression and irritation. Repeated pressure or trauma can cause the nerve to become inflamed and develop a fibrous thickening, known as a neuroma. This thickening compresses the nerve further, leading to the characteristic symptoms.
Patients with Morton’s neuroma typically present with:
Symptoms are usually unilateral but can affect both feet in some cases.
Diagnosing Morton’s neuroma involves a combination of clinical evaluation and imaging studies:
Treatment of Morton’s neuroma typically begins with conservative measures, progressing to surgical intervention if necessary.
Surgery is considered when conservative treatments fail after several months. The goal is to remove the neuroma or decompress the nerve.
The most common surgical procedure is neurectomy, which involves excision of the affected nerve segment.
In some cases, decompression surgery (releasing the ligament compressing the nerve) may be performed instead of excision.
As with any surgery, there are potential risks:
The prognosis for Morton’s neuroma is generally good, especially with early diagnosis and appropriate treatment. Many patients experience significant symptom relief with conservative measures. Surgical excision has a high success rate, with approximately 80-90% of patients reporting improvement. However, some may experience residual numbness or discomfort.
Morton’s neuroma is a painful condition caused by nerve irritation in the foot, commonly affecting the area between the third and fourth toes. Understanding its causes, symptoms, and treatment options is crucial for effective management. Conservative treatments often provide relief, but surgery may be necessary in persistent cases. If you experience symptoms suggestive of Morton’s neuroma, consult a healthcare professional for proper diagnosis and personalized care. Early intervention can help you return to pain-free walking and an active lifestyle.