Mortons Neuroma
Inflammation of the digital nerve. Usually between the 3rd and 4th metatarsals. It is often worse in closed in shoes.
What is Mortons Neuroma?
Inflammation of the digital nerve. Usually between the 3rd and 4th metatarsals. It is often worse in closed in shoes. It is characterised by neural pain or parasthesia (burning, tingling, shooting pain or numbness) that extends into the digit(s)/toes.
What is the cause?
Tight footwear, or lateral forefoot compression (poorly fitted footwear) often contribute, as well as excessive plantar pressure or a recent increase in lateral plantar forefoot pressure, which causes an increase in inter metatarsal pressure, the pressure in between your metatarsals. This compresses the nerve and if it is, or becomes inflamed can cause symptoms.
Keep in mind that Mortons neuroma is often seen on scans, and people report no symptoms, so in some cases, a thickened digital nerve is not always the problem, it is only that it has become irritated.
What is the treatment?
Reducing the intermetatarsal compression, and/or plantar pressure.
More appropriate footwear fitting advice.
Metatarsal domes can be effective in increasing the space between the metatarsals and therefore reducing pressure on the nerve.
Changing foot mechanics using cushioning materials and orthoses to reduce lateral plantar forefoot pressure.
Cortisone injections can be helpful acutely, though we often like to reduce the pain prior to injection to reduce the irritation. In other words it is helpful to use your pain to make sure what we are doing is working. Once you have relief, the cortisone can help eliminate your pain and since we know we have reduced pressure on the area, it is less likely to return.
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