As promised last week, we are going to talk about Morton’s neuroma this week. (Or as I will call it in my mind (and apparently at least once here…) Durlacher’s neuroma. For an explaination, see last week’s post. )
Morton’s neuroma falls under two categories that we have been talking about for the past few weeks. Frequently with Morton’s neuroma, you will have ball of the foot pain. It will feel like you are walking on pebbles. Also, there could be numbness in the toes.
The pain or discomfort associated with Morton’s neuroma is generally coming from between the third and fourth toes. It can occasionally be found between the second and third toes.
There is not an outward sign of the neuroma. There is not a lump visible even though the tissue surrounding the nerve between the toes has thickened. This thickened tissue has put increased pressure on the nerve.
What causes Morton’s neuroma?
There are several things that can cause a neuroma to form.
1. Foot structural issues. The presence of structural issues like bunions, hammertoes, flat feet or high arches can put added pressure on the ball of the foot which will put a person at higher risk for developing a neuroma.
2. Sports. Subjecting your feet to repeated trauma such as running and jogging can also cause repetitive injuries that will form a neuroma. Also, sports that require the use of tight fitting shoes or boots (like skiing and rock climbing) can squeeze the foot and a neuroma can form.
3. Tight shoes. Repeated use of tight shoes that compact your foot bones can cause pressure that will be the source of a neuroma.
How do I know I have a neuroma and what do I do?
The only way to absolutely know is to go see your friendly local podiatrist. There are some indications and some things you can do to ease the situation.
As I said before, if you feel like you have a pebble in your shoe when you walk, see if your foot feels better when you take off your shoes. Fortunately, neuromas do not generally cause pain at night when you are trying to sleep. If you find that your foot hurts more in some shoes than others, look at the difference in the shoes. It may be that switching to a lower heel or a larger toe box will help.
You can try over the counter inserts in your shoes to relieve the pressure on the ball of your foot. You can also try an ice massage. (Freeze a water filled disposable cup with water and then roll the ice over where you feel the pain.)
You should also rest for a few weeks form high foot impact activities. Take a break from running, jogging, walking, and dancing for a short time to let the area recuperate.
When should I go to the doctor?
If you have persistent pain in your foot (more than a few days) then you should go to visit your friendly local podiatrist. If you want to try the suggestions listed above and see if they make a difference, please do. If, after a few days they don’t make a difference, then go to the doctor. Don’t forget to tell your doctor the changes that you made and if they seemed to help at all with your pain level.
Why should you be in pain? Go see a professional so that you can move toward easing the problem.
What will the doctor do?
The doctor will feel your foot. There are times that with this manual exam, the doctor can feel the lump inside your foot or can tell from the way the bones move on examination that there is a neuroma. The doctor may have an x-ray taken to see the bone structure in your foot. While soft tissue does not show up on an x-ray, the separation of the bones does show up. It could be that the doctor feels that an ultrasound or MRI is necessary. Once the doctor is firm in the diagnosis of Morton’s neuroma, the two of you can discuss how to proceed.
If you have not already taken the steps outlined above, the doctor may recommend those steps. It may be that over the counter foot pads are not enough for your foot structure. The doctor may recommend that an orthotic be cast for your foot. That orthotic can be moved from one pair of shoes to the next so that your foot is always supported.
If conservative treatments don’t help you, the doctor could recommend an injection or perhaps surgery. It all depends on your situation and your conversation with the doctor.
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Have a good rest of the week!