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Mortons Neuroma Causes
02.06.2017 11:48
Overview

intermetatarsal neuromaMorton's neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. Morton's neuroma may feel as if you are standing on a pebble in your shoe or on a fold in your sock. Morton's neuroma involves a thickening of the tissue around one of the nerves leading to your toes. This can cause a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb. High-heeled shoes have been linked to the development of Morton's neuroma. Many people experience relief by switching to lower heeled shoes with wider toe boxes. Sometimes corticosteroid injections or surgery may be necessary.

Causes

It's not always clear what causes Morton's neuroma, but several things seem to aggravate it. These include other foot-related problems and wearing restrictive footwear. It's thought that Morton's neuroma may be caused by the toe bones (metatarsal bones) pressing against the nerve when the gap between the bones is narrow. This causes the nerve and surrounding tissue to thicken.

Symptoms

Patients will feel pain that worsens with walking, particularly when walking in shoes with thin soles or high heels. Also, anything that squeezes the metatarsal heads together may aggravate symptoms, such as narrow shoes. A patient may feel the need to remove the shoe and rub the foot to soothe the pain.

Diagnosis

The physician will make the diagnosis of Morton's neuroma based upon the patient's symptoms as described above in an interview, or history, and a physical examination. The physical examination will reveal exceptional tenderness in the involved interspace when the nerve area is pressed on the bottom of the foot. As the interspace is palpated, and pressure is applied from the top to the bottom of the foot, a click can sometimes be felt which reproduces the patient's pain. This is known as a Mulder's sign. Because of inconsistent results, imaging studies such as MRI or ultrasound scanning are not useful diagnostic tools for Morton's neuroma. Thus the physician must rely exclusively on the patient's history and physical examination in order to make a diagnosis.

Non Surgical Treatment

Rest. Continuing with normal training will increase pain and inflammation and prevent the injury from healing. Wear a metatarsal pad under the forefoot which will raise and spread the bones of the forefoot taking the pressure off the nerve. Wearing metatarsal pads in the shoes under the forefoot spreads the metatarsals creating more space for the nerve. See a sports injury professional who can advise on treatment and rehabilitation. Orthotic inserts may be required to correct any biomechanical dysfunction of the foot.interdigital neuroma

Surgical Treatment

Interdigital neurectomy (removal of the diseased nerve) in right hands, should give satisfactory results almost all the time. Some of the reasons behind failure is when not enough nerve is dissected, mistakes in initial diagnosis, or bad handling of adjacent nerves, tendons and joint capsules during the operation. It is very common and acceptable to have some numbness in the area where the nerve used to be. This never causes any discomfort and often gets better in few years. It is crucial to address the biomechanical pathologies underlying the impingement of the nerve during and after the surgery.

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