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Morton's Neuroma

What is a Morton’s neuroma?

It is thickening of the nerve tissues caused by repetitive trauma such as compression, irritation, and inflammation. The affected nerve is the common digital plantar nerve, it runs between the metatarsal head (long bone of the foot) and passes under the ligament that connect these bones. They supply sensation to the ball of the foot and toes. Due to the anatomical position of this nerve, they are prone to injuries and the most common affected site is the 3rd intermetatarsal, the space between the 3rd and 4th metatarsal.

There are a number of contributing factors to the development of a Morton’s Neuroma:

  • Narrow shoes which creates compressive pressure on the nerve.

  • High-heeled shoes and tight calf muscles increase forefoot loading in gait.

  • Flat feet, bunion or high arch foot all lead to overloading of the 2nd to 3rd metatarsal heads due to insufficient function of the 1st metatarsal.

  • Any high impact sport such as running or court sport result in repetitive pressure and irritation to the ball of the foot.

This condition is commonly occurred in middle-aged women and 5 times more common in women compared to men.

What are the signs and symptoms?

  • Pain

  • Numbness/tingling/burning sensation in the toes

  • Sensation of walking on a stone or marble

  • Sensation of something in the shoes or sock scrunched up.

Diagnosis of Morton’s Neuroma

  • Palpation at the intermetatarsal space can reproduce the symptoms

  • Squeeze test at the forefoot can result in a clicking feeling which is known as the “Mulder’s click”.

Treatment/Management of Morton’s Neuroma:

  • Changes to foot wear choice such as wider toe box shoes and low heel

  • Padding such as metatarsal pads to reduce intermetatarsal irritation

  • Orthoses therapy to reduce forefoot loading, irritation and compression forces on the nerve.

  • Activities modification to reduce repetitive pressure on the neuroma

  • Exercises such as calf stretches and plantar foot stretches.

  • Foot Mobilisation technique to improve joints mobility

  • Photobiomodulation therapy ( Low Laser Therapy) to reduce inflammation and pain.

  • Medication such as oral nonsteroidal anti-inflammatory drugs ( NSAIDs) for example ibuprofen

  • Corticosteroid injection

However, if symptoms persist with the above management. Then surgical intervention might be required which involves the excision of the neuroma.

If you are experiencing any of the symptoms please give us a ring on 08 8186 1863. We will assist you in your journey to return to your activities.


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