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The term neuroma refers to a swelling of a nerve. The nerve commonly affected is a small nerve that connects the 3rd and 4th toes, counting from the big toe. When this nerve between the 4/5 or the ¾ toes is affected then the condition is known as a Mortons Neuroma and between the other digits it can be referred to simply as a plantar digital neuritis.
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Symptoms of Mortons Neuroma include a burning sensation in the ball of the foot – commonly described as having a hot poker pushed into the foot, and this is accompanied by the feeling of pins & needles in the toes or numbness in the toes. The problem is made worse when wearing tight fitting shoes – high heels or tight sports shoes such as football boots. Patients often complain of feeling like there is a lump in the ball of their foot and almost all will report that removing shoes and walking on a cold surface (tiled floor) will help alleviate the symptoms a little.
The treatment for Motons neuroma is relatively simple and successful. Treatment should always follow these steps – reduce the mechanical stress that caused the problem, inject with steroid if necessary and remove if all else fails.
You should expect the pain to subside quite quickly if footwear advice and orthoses have been implemented. The nerve can reduce in size over time however in most cases the area of enlarged nerve will be permanent and treatment needs to be ongoing. In most cases Mortons Neuroma can be treated very successfully in a conservative manner.
It is important to diagnose this problem accurately as it is easy to classify it as metatarsal pain and treat it in a less appropriate manner. Diagnosis is made using a combination of clinical symptoms and eliciting a Mulders Click when examining the foot.
Further diagnostic tests such as ultrasound or MRI can give a more definitive diagnosis but are usually only advised if surgery is being considered.
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