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Plantar Neuroma (Morton's Neuroma )

Morton's neuroma is a non-cancerous tumor of a nerve. It is more common in women than in men.

It usually occurs in the space, between the third and fourth toes.

Morton's neuroma, is also called plantar neuroma.

Causes

• Relaxation of the ligaments of the foot causing thickening of the plantar nerve.
• Ill-fitting shoes (possibly), particularly shoes used for athletic activity.
• Repeated foot injuries.
• Obesity and poor nutrition.
• Recent or chronic illness.
• If surgery is used for treatment, surgical risk increases with: smoking; use of drugs such as antihypertensives, muscle relaxants, tranquilizers, sleep inducers, insulin, sedatives, beta-adrenergic blockers or cortisone; use of mind-altering drugs, including narcotics, psychedelics, hallucinogens, marijuana, hypnotics or cocaine.

Signs and symptoms

Early stages:

• Excruciating pain in the front part of the foot, particularly when running or bearing weight while jumping, turning or dancing.

Later stages :

• Localized pain in the sides of the 3rd and 4th toes (usually). Pain occurs suddenly when least expected. Removing the shoe and massaging the painful area brings dramatic relief almost immediately. Pain is less when barefooted.
• Tenderness at the base of the 3rd and 4th toes.
• Feelings of electric shock or numbness running out into one or both toes.

Diagnosis

Your doctor will ask about your symptoms and examine your foot. Because there's typically no outward sign of Morton's neuroma, your doctor will try to find a palpable, tender mass. There may also be a feeling of "clicking" between the bones of your foot. Your doctor may order an X-ray of your foot to rule out other foot problems.

Treatment

Medical Treatment - Your doctor may prescribe a trial treatment with a metatarsal bar in the shoe. If this fails, surgery will be necessary.

Medication- After surgery, your doctor may prescribe:

• Pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need.
• Antibiotics to fight infection.
• Non-prescription drugs, such as acetaminophen, for minor pain.

Home Treatment

After surgery, the foot will be snugly wrapped in a bandage. Keep the bandage dry and the foot elevated as much as possible during recovery. After removal of bandages, apply heat with soaks, tub baths or heat lamps. When healed, massage with ice for 10 minutes before and after vigorous physical activity.

Prevention

• Change your footwear . Avoid high heels or tight shoes. To make sure that your toes aren't cramped, choose shoes with enough room in the toe box or wear sandals.
• Wear supports or pads . Arch support or foot pads may help reduce pressure on the nerve.
• Take a break. For a few weeks, reduce activities such as jogging or aerobic exercise or dancing that subject your feet to high impact.