Morton’s neuroma is a common foot syndrome, especially among women, that causes pain, tingling, and numbness in the toes.
We discussed this condition with a few experts to understand more about it.
What is Morton’s Neuroma?
Morton’s neuroma, also known as interdigital neuroma, is named after Dr. Thomas G. Morton. It is a degenerative condition that affects a nerve located in the forefoot region.
The condition involves the enlargement of the interdigital nerve, usually between the third and fourth spaces of the toes. This enlargement is primarily caused by mechanical factors, leading to thickening of the nerve due to the growth of fibrous tissue around its protective membrane.
As a result, a “ball” or mass forms near the site where the nerve branches out between the toes. Compression of this mass causes the characteristic pain, often described as an “electric shock” sensation between the toes.
Causes
As mentioned earlier, Morton’s neuroma is caused by the compression of the interdigital nerve between the metatarsal heads and the intermetatarsal ligament.
This compression can occur due to:
- mechanical factors
- wearing shoes with thin soles
- wearing uncomfortable women’s shoes.
Symptoms
The primary symptom is pain in the sole, which can radiate to the toes. Since this condition affects the peripheral nervous system, individuals may also experience unusual sensations, such as tingling, in the toes.
When to Seek Specialist Evaluation
If you experience recurring pain, even if it is not constant, for more than a month, it is advisable to consult a specialist for evaluation and diagnosis.
Diagnosing Morton’s Neuroma
The orthopedist can use a specialized examination to differentiate between suspected Morton’s neuroma and other conditions that cause forefoot overload, such as:
- Intermetatarsal bursitis
- Synovitis of the metatarsophalangeal joints
- Stress fractures of the metatarsals.
Ultrasonography is commonly used to confirm the diagnosis, and in some cases, Magnetic Resonance Imaging (MRI) may be helpful.
Conservative Treatment for Morton’s Neuroma
In conservative therapy, the footpad may be seen as a burden rather than providing relief. However, an alternative option is sclero-alcoholization, which falls somewhere between surgery and conservative treatments.
Sclero-alcoholization is performed under ultrasound guidance by injecting anesthetic and alcohol into the affected interdigital space using a needle. This chemical neurolysis induces dehydration and necrosis in the nerve cells.
Surgical Treatment for Morton’s Neuroma
When Morton’s neuroma is accurately diagnosed, surgery may be considered to remove the neuroma and the affected nerve’s distal portion.
The nerve should be removed just before it splits at the interdigital level. This procedure can cause temporary sensory changes, which can be uncomfortable for some patients, particularly in the first few months after surgery.
The surgical procedure is typically performed as a day surgery under peripheral anesthesia.
