Foot Pain (Morton's Neuroma)
Morton's Neuroma is a condition first described by Dr. Morton, a Viennese physician, in 1876. The condition is a result of nerves that are irritated or pinched between the bones in the ball of the foot. There are five metatarsal bones that comprise the ball of the foot. These are the long bones that extend back from the toes. Nerves course between these metatarsal bones on their way to providing sensation to the corresponding toes. If we count the big toe as number one, the most common area for Morton's Neuroma to occur is between the third and fourth toe. The reason morton's neuroma occurs more frequently in this area is because it is the only area in the front of the foot where two nerves come together. Therefore, in this particular area, (between the third and fourth metatarsal), the nerve is double the size than any other metatarsal space.
As the particular nerve is irritated by the heads of the two adjacent metatarsal heads, the nerve becomes irritated and inflamed, over time it becomes enlarged. Walking and wearing tight shoes squeezes the two metatarsals together sending a painful sensation into the two affected toes. The sensation can be sharp, electric shock like, burning, pins/needles and/or numbness. Sometimes the pain is relieved by taking off the offending shoe and massaging the ball of the foot.
Diagnosis of Morton's Neuroma is made by performing a simple test. The Podiatrist will gently squeeze the foot from side to side and use a thumb to push up between the third and fourth metatarsal heads. In advanced cases of Morton's Neuroma, there will be a snap or clicking sensation felt in the area .This is called a positive Mulder's Sign. The Mulder's Sign mimics what takes place in the shoe with every step. Squeezing the foot simulates the shoe and pushing up on the bottom of the foot simulates the reactive forces of the ground as it pushes against the foot with each step.
Footwear can be a contributing to the symptoms of Morton's Neuroma by binding the front of the foot and compressing the nerve. Higher heels and narrow fitting shoes exasperate the symptoms by acting to increase the ground reactive forces. In advanced cases, people can also have neuroma pain in any style shoes or even barefoot. Approximately fifty percent of Morton's Neuromas can be effectively treated with conservative therapy, preventing the need to resort to surgery.
Our Podiatrist can help alleviate the pain associated with morton's neuroma using conservative therapy which includes:
- Padding - pressure relief that separates the affected metatarsal bones
- Prescription orthotics
- Better fitting footwear
- (LLLT) low level laser therapy
- Ultrasound Therapy
- Cortisone injections - also referred to as steroid injections, these injections can alleviate pain and reduce the inflammation around the affected nerve.
- Neural Prolotherapy - Natural or homeopathic injection, which can help alleviate pain and reduce inflammation preventing pain in the affected nerve and surrounding tissue.
- (PRP) Platelet rich plasma injections - Platelets are the super cells in our body that help heal tissue and reduce pain naturally by affecting the chemical receptors in our body, causing new tissue formation, this treatment has also been shown to benefit other nerve related conditions in the foot, i.e peripheral neuropathy, nerve damage etc.
Our Podiatrist can refer you to a local Podiatric surgeon, In chronic cases a surgical procedure is used to excise part of the affected nerve. This surgical treatment has been used for decades and can have it's drawbacks including permanent numbness in the affected two toes, regrowth of the nerve and time off one's feet for recovery.
At My Foot Doctor we have a revolutionary new treatment, that can help alleviate the pain associated with morton's neuroma. Our podiatrist has several years experience treating Morton's Neuroma in both male and female patients. She has included two patient case studies. where conservative treatment has failed to reduce pain completely, therefore other treatments methods such as low level laser therapy LLLT was used to treat acute and chronic cases of morton's neuroma, LLLT is a revolutionary new treatment which is pain free, non invasive, with no side effects, this innovative treatment can help alleviate the cause and symptoms associated with morton's neuroma.
Here are two very different Morton's Neuroma(MN) case studies, who have had great relief after LLLT treatments which are pain free, non invasive, no side-effects.
Patient A - developed the (MN) about four years ago on her left foot, at the base of her toes. She tried a steroid injection, which gave her short term pain relief 3-6 months, patient then had second steroid injection at local hospital, but described it as (agony and no improvement) patient then had surgery, but has since developed two more (MN) spots on the same foot around the scar tissue, and also the right foot has developed (MN). She could not walk for more than 10 - 15 minutes without severe pain and could spend very little time on her feet, so her life was really restricted by this condition.. She felt great improvement after the first treatment, pain has reduced and she is now well on the way to resuming normal activity.
Patient B - has had MN on her right foot for at least two years, and has tried various different insoles, she also tried acupuncture but experienced no improvement after one years treatment, Gp had offered steroid injection however patients wasn’t keen on possible side-effects that may develop. Her pain starts after walking/or running for about an hour despite using insoles etc, she is a keen walker and this condition was preventing her enjoying her weekend activities, Her normal walking to and from work etc was slightly but not badly affected. The first few treatments did not seem to make much difference, however the patient was determined to avoid surgery so we persisted with the course of 8 sessions and the results were very good. She can now resume her 5 to 10 miles run on her weekends.
if you think you may have Morton's Neuroma call us on: 01698 860070 to book a podiatry consultation appointment, consultation cost is: £35.00
During your first consultation, the podiatrist will take a full medical history, pain and symptoms history, carry out a clinical assessment of the foot and she may perform a number of clinical tests to diagnose morton neuroma, this allows our podiatrist to recommend the best course of treatment for your foot condition. You can also book at My Foot Doctor using our online booking button below.