Morton’s Neuroma
by Stephanie on August 6, 2010
What is it ?
This condition is a painful compression of a nerve just before it goes into two of the toes on the foot most commonly the 3rd and 4th toes but sometimes the 2nd and 3rd. In the diagram below, you can see that the nerve divides into 2 parts right at the point where the space between the bones is narrowest. If the nerve gets squashed repeatedly, the nerve will thicken, forming mass on the nerve at this point. The bigger the nerve gets, the more likely it is to get caught between the bones and the problem can escalate to become increasingly painful.
What are the symptoms ?
Pain will occur almost exclusively in shoes. The pain comes in a sharp zap that feels a bit like an electric shock that extends into the two adjacent toes. There is often a click feeling that occurs at the moment of the zap.
What causes it ?
The things that can cause the problem to begin all involve ways in which the space between the two long bones is lessened. These include having an unusual shape to those bones, wearing shoes that squeeze the bones together side-to-side or having feet that pronate or roll in. The pronation makes a difference because the heads of the long bones are deeper than they are wide. When the foot is straight up and down so are those bones which means they are at their thinnest . When feet roll in, the bones rotate and take up extra room side to side.
What is the solution ?
Taking care with shoes is the first step. It s possible to bring about the problem with a single bad shoe purchase. Ensure that your shoes don t squeeze you across the ball of the foot. To treat the pain, if it is a simple case, the podiatrist will mould a silicon pad between the toes which may be sufficient. If it is worse, various sorts of padding to deflect pressure are used. At times, a shoe insert called an orthotic may be required to increase the space between the metatarsals by straightening them up. These methods will solve the problem 98% of the time. Around 2 % of the time, the nerve may need to be injected with steroid or occasionally surgically removed altogether.