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Posted on: September 13 2021

A neuroma or otherwise known an Morton”s neuroma, is a thickening of the plantar digital nerve in the forefoot just in front of the toes. It occurs in the restricted space between the heads of two adjacent metatarsals (or very close by), usually between the 3rd and 4rd metatarsals, but can occur between any of the metatarsals. The nerve bundle thickens with time.

 

 

 

Due to the restrictive space, the thickening leads to friction, and constriction on the nerve bundle from the surrounding structures, causing the nerve to get compressed and irritated and entrapped. This sends the pain signals. Nerve pathology will have specific symptoms, usually a combination or several of the following- burning, numbness, ache and or shooting pains in the region of the damage and or further down, in this case often into the toes.

These symptoms classically occur during weightbearing, more often at the propulsive stage of walking when all the weight/forces passes through this region. The condition may be aggravated by narrow toe box shoes (dressy shoes), abnormal mechanics of the foot, and irritation of the plantar digital nerve where it travels through the transverse ligament.

Treatment can vary, but often begins with shoe assessment, paddings, laser and sometimes orthotics. when more conservative options fail, injection therapy can be very effective, and can in some circumstances be done under ultrasound guidance. Cheltenham Podiatry has a highend ultrasound onsite allowing for better visual details of intricate foot anatomy, and well experienced podiatrists whom have had training overseas.

 

Ultrasound image, 3d– is 3rd metatarsal, 4th is 4th metatarsal

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