Late examination and diagnosis can cause the development of serious diseases, which also include Morton's neuroma. Discomfort in the legs is a terrible inconvenience for many people, but not everyone goes to the doctor with this problem.
This is a fairly common disease that manifests itself as a thickening of the nerve of the foot, causing severe pain. When the first signs of this disease appear, you should definitely undergo an examination by a doctor.
Morton's syndrome is a condition that causes thickening of the nerves in the foot. When Morton's neuroma occurs, the bones and ligaments begin to put pressure on the nerves passing through the area, resulting in an inflammatory process. The development of this disease in most cases occurs in women, which is due to the active wearing of tight and uncomfortable shoes, often with high heels. Excess weight can also cause this disease, which causes the foot to be subject to excessive pressure while walking.
When such a disease of the extremities appears, people experience significant discomfort, since the first signs are shooting pains, numbness in the fingers, tingling and burning. Most often, the location is between the 4th and 3rd fingers, but in some cases it is also possible between the 3rd and 2nd fingers. If you suspect a neuroma, before choosing which doctor to see, you should familiarize yourself in detail with the symptoms and nature of this disease.
Morton's neuroma can be diagnosed even in the early stages, but more often patients with neuroma during this period prefer independent attempts at treatment at home. Only after severe pain occurs do they turn to different doctors:
The patient may also complain of a sensation of a foreign object in the foot. First of all, the diagnosis of Morton's neuroma consists of interviewing the patient to clarify the location of the pain and the type of shoes he wears. In addition, additional diagnostic techniques for diagnosing Morton's neuroma may be prescribed, for example, the following procedures:
X-ray images allow differentiation from other diseases with similar symptoms. To clarify the diagnosis, an external examination of the foot is performed, during which the sole of the foot is compressed to identify the area of the affected nerve, the area of numbness and pain. By palpation, a neoplasm can be detected on the nerve trunk, which accurately confirms the diagnosis.
The most common cause of Morton's neuroma is severe stress on the feet, which can occur while walking. This may be due to improper gait, frequent wearing of high-heeled shoes, as well as tight or uncomfortable shoes. Interdigital neuroma most often occurs in people who are actively involved in sports or when standing for a long time while working. There are other possible causes of development when an intermetatarsal neuroma appears:
A neuroma on the leg can appear due to exposure to any factors that cause compression or irritation of the digital nerves.
When Morton's neuroma occurs, the main symptoms are pain between the toes and numbness. Patients also complain of a sensation similar to when a foreign object gets into their shoes. The pain syndrome is primarily associated with wearing tight shoes, and when removing them, patients may feel relief. The manifestation of these signs may periodically disappear, and then resume again. When symptoms of Morton's neuroma occur, treatment depends on what stages of development the process is at.
Gradually, the pain transforms, becoming severe and constant, which is why patients often seek medical help in the later stages of the disease. Often, conservative treatment of such patients will not be effective. In this case, surgical treatment would be rational - removal of Morton's neuroma.
Symptoms and treatment of this disease mainly depend on the stage of development. If the pathology is detected in a timely manner, treatment is carried out using a conservative method. In advanced cases, surgical intervention is necessary to cure neuroma. The doctor can determine the method of treatment only after an accurate diagnosis. Often, due to the late presentation of patients to the hospital, Morton's neuroma is treated surgically.
Typically, conservative therapy begins with replacing shoes with more comfortable ones. During the period of treatment, orthopedic insoles can be used. This does not affect walking in any way, but allows you to avoid excessive stress on your legs. It is important to purchase orthopedic insoles only in specialized stores or have them made individually after scanning your feet. If they do not meet production standards or foot size, this can only make the situation worse. First of all, conservative therapy is aimed at:
The patient should also stand as little as possible and avoid long walks.
To alleviate the patient’s condition, he is prescribed medications that relieve pain:
To cure a neuroma, the doctor may prescribe physiotherapy procedures: magnetic therapy, electrophoresis, acupuncture and massage. They are aimed at stabilizing blood circulation processes and restoring nerve cells. If Morton's neuroma can no longer be treated conservatively, surgery is necessary.
Removal of Morton's neuroma by surgery can be of two types:
Treatment can also be carried out with the help of timely equipment, when a laser is used for surgical intervention. Whatever method the doctor chooses, after surgical manipulations the patient will be able to return to everyday life, fully moving on both limbs.
Treatment of Morton's neuroma at home can be carried out using traditional medicine techniques. Treatment with folk remedies helps to cope well with the disease, eliminating the inflammatory process and attacks of pain. If a neuroma of the foot has formed, you can use popular folk remedies:
Folk remedies are best used as an addition to basic conservative therapy. Unqualified self-medication can cause significant complications and consequences.
If Morton's disease progresses for a long time, but the patient does not seek medical help, the consequences can be very serious. The pain syndrome will gradually become stronger, and the inflamed area will grow. As a result, treatment can only be carried out through surgery. Patients with an advanced form of the disease may require rehabilitation for two weeks to return to normal activities.
You can prevent the occurrence of this disease by using comfortable shoes of the appropriate size. Women who prefer high heels are recommended to have relaxing massages and foot baths in the evenings. If you have flat feet or other foot deformities, you should give preference to wearing special orthopedic insoles.
Neuroma can cause serious problems with movement, as its symptoms manifest themselves quite clearly, in particular pain. To prevent the progression of this disease, it is worth going to the hospital at the first sign and undergoing examination. Timely diagnosis and modern methods of therapy will allow you to get rid of the disease and maintain proper gait.
No comments yet. Be first! 2,668 views
Morton's neuroma is a disease in which a benign growth forms between the metatarsal heads of the third and fourth toes. Pathological thickening of the nerve of the foot is inflammatory in nature. Morton's disease often affects middle-aged women who wear uncomfortable shoes or injure their feet in other ways. Let's take a closer look at the main symptoms of the disease, as well as the treatment for Morton's neuroma.
Morton's syndrome usually affects only one foot. There are rare cases of damage to both feet at once. The symptoms of the disease are as follows:
Very often the patient ignores these symptoms, since they appear inconsistently. Signs make themselves felt only during long walks or wearing not very comfortable shoes.
Symptoms completely disappear for a while after a foot massage or regular relaxation on the couch.
If the pathology begins to progress, completely different symptoms are noted, such as the forefoot begins to tingle strongly, the foot often becomes numb and loses its sensitivity. A person feels a foreign body between his fingers, although it is not there.
Morton's neuroma has no external signs. In some cases, the foot may swell or swell in the affected area.
In older people, the protective function of the shock-absorbing fat layer in the heads of the metatarsal bones decreases. Because of this, a phenomenon called metatarsalgia occurs. It compresses the bags in the heads of the metatarsal bones and causes the development of bursitis - inflammation of the joints and ligaments. Metatarsalgia is treated with special orthopedic insoles or wearing special shoes.
If you notice symptoms of a neuroma, be sure to go to the doctor. The specialist will conduct an examination, make a diagnosis and prescribe treatment. Which doctor should I contact with this problem? Morton's neuroma is treated by a surgeon, neurologist and orthopedist.
The specialist performs magnetic resonance imaging, radiography, and ultrasound. Thanks to an ultrasound of the foot, it is possible to determine the exact location of the tumor, as well as its size.
Based on the results of the study, the doctor prescribes treatment with conservative, surgical or folk remedies.
Neuroma can be treated using both conservative and surgical methods. After consultation with a doctor, the disease can be treated at home.
A conservative method of treating neuroma is to improve the functionality of the foot and reduce the load on it. It is used in the initial stages of the disease.
Neuroma of the foot is treated with the following conservative methods:
Reduce the load on the affected foot - try to walk less or stand in one place for a long time.
Wear wide-toed, low-heeled shoes. Be sure to buy orthopedic insoles with special inserts. In some cases, your doctor may recommend using finger separators.
Massage your feet from ankles to toes daily.
Morton's finger is treated with non-steroidal anti-inflammatory drugs in the form of tablets or ointments. For example, Ibuprofen, Diclofenac, Nimesulide.
Advanced disease requires treatment with corticosteroids.
If you follow these recommendations, the pain will disappear within three months. If the pain becomes even stronger, the doctor may prescribe medications to reduce pain - Codelac, Solpadeine, Terpinkod.
Advantages of conservative treatment:
The negative side of treating the disease using conservative methods is that treatment will take a long time and cost a lot of money. Taking some drugs orally can cause problems with internal organs.
If conservative treatment methods do not produce results, the doctor is forced to perform surgery. Morton's finger is treated with the following surgical methods:
Removal of formation. The doctor makes an incision between the 3rd and 4th fingers, then removes the neuroma and applies stitches. after 14 days, the stitches are removed.
Very rarely, excision of the inflamed area of the foot is performed. The operation leaves the fingers numb and the patient feels no pain.
Sometimes the bone is broken artificially. After such an operation, the patient will require long-term rehabilitation.
Surgical intervention in the first case allows the patient to be at home within a couple of hours after the operation. This treatment is more economical and allows you to completely eliminate the problem in the foot area.
The disadvantages of surgical treatment of Morton's neuroma include long-term rehabilitation and slight discomfort while walking.
Treatment with folk remedies can be carried out as an additional method to the main treatment of the disease. Morton's finger can be treated at home in the following ways:
Compresses with wormwood. Grind the fresh leaves of the plant and apply the pulp to the affected foot. Secure with a bandage. It is recommended to apply compresses at night.
Add chamomile decoction and salt to water at a temperature of 39 degrees. Place your feet in the basin for 15 minutes. After the bath, dry your feet well.
Morton's neuroma can also be treated with pork fat and salt. Mix pork fat (100 grams) with salt (15 grams). Rub the resulting product into the sore foot. Secure with a bandage. Go to bed. In the morning, remove the bandage.
It is important to remember that traditional medicine does not eliminate the symptoms of the disease, it only helps to alleviate the patient’s condition.
Now you know what Morton's neuroma is, what are its main symptoms and treatment methods. It is important to strictly follow the doctor's recommendations in order to completely cure the disease.
Morton's neuroma is a specific fibrous growth of plantar nerve tissue that is benign in nature. This pathological condition in medical practice is known as neuroma, or Morton's disease, interdigital neuroma, neuritis of the plantar nerve of the 3rd and 4th fingers, perineural fibrosis, etc. This disease is quite rare. Most often, this condition is observed in women who have crossed the 50-year age limit. In men, neuromas are much less common.
The growth of the nerve endings running between the 3rd and 4th toes is accompanied by the appearance of a pronounced pain syndrome. It is worth noting that without proper treatment, neuroma, as a rule, continues to increase in size, causing the patient a lot of discomfort. Timely therapy allows you to cope with this pathological condition using conservative methods, so if you experience pain in the area of the 3-4 toes, you should definitely consult a doctor. If symptoms fully manifest themselves and treatment is not started, complications may occur.
At present, not all factors contributing to the development of such a pathological condition as Morton's neuroma have been identified. Considering that Morton's neuroma most often affects women who prefer tight, high-heeled shoes, it becomes clear that the main reason for the appearance of such a formation is trauma to the foot due to its systematic overload. Wearing uncomfortable, low-heeled shoes that are too narrow can also trigger the development of Morton's neuroma. Other causes of Morton's neuroma include:
External reasons, as well as with systematic overload of the foot. The nerve ending running between the 3rd and 4th fingers becomes pinched and begins to change its structure. In the vast majority of cases, as the neuroma increases in size, an inflammatory process occurs. Most people suffering from Morton's neuroma affect both legs at once, which causes significant discomfort.
Symptomatic manifestations of Morton's neuroma (while this benign neoplasm is still small in size) can occur only from time to time. In most cases, people suffering from neuroma located between the 3rd and 4th toes do not pay any attention to the first signs of the disease, considering them the consequences of a hard day spent on their feet. However, later the symptoms begin to manifest themselves in a chronic form, which forces patients to seek medical help. The most characteristic symptom of Morton's neuroma is pain in the foot, which is most clearly felt in the area between the 3rd and 4th toes. The pain syndrome usually intensifies significantly while the patient is in a standing position.
At night, pain, as a rule, does not bother patients suffering from Morton's neuroma. In addition, with significant growth of Morton's neuroma, short-term lumbago, severe pain, is not uncommon. Among other things, significant discomfort may be observed in the foot, since the mobility of this part of the leg is significantly reduced. As the inflammatory process develops and the neuroma increases in size, a burning sensation or insemination of the fingers may appear. Considering that inflammatory processes also affect nearby soft tissues, the area of edema is usually clearly marked. In rare cases, a slight swelling may appear in the area under the 3rd and 4th toes. Many people suffering from Morton's neuroma report a foreign body sensation in their shoes.
Considering that a neuroma is not a tumor in the full sense of the word, but only a fibrous thickening located between the bones, there are, as a rule, no external manifestations of this formation. Over a long period of time, symptoms of Morton's neuroma increasing in size may appear only from time to time, but after a certain period, patients note that the duration of manifestation of the characteristic signs of the disease gradually increases. The pain may acquire a constant pulsating character and not leave the patient while he is in a standing position. Even in severe cases, Morton's neuromas usually do not cause significant symptoms when the person is at rest and there is no weight bearing on the foot.
When signs of the development of Morton's neuroma appear, the patient naturally asks the question of which doctor to see. To diagnose and prescribe treatment for Morton's neuroma, you must consult a neurologist. In the vast majority of cases, a thorough examination of the foot and analysis of the patient’s groove is sufficient for a qualified neurologist to make a diagnosis. By palpating and identifying areas of tenderness, the doctor can also determine the size of the existing formation.
In some cases, to exclude other conditions that can cause similar symptomatic manifestations, MRI or radiography is prescribed. These tests can help rule out broken bones, arthritis, or other conditions that cause pain in the toes. In the presence of severe pain and to determine the exact location of the neuroma, local anesthetics may be administered. After conducting all the necessary diagnostic tests, the doctor determines how to treat a particular patient.
Treatment with conservative methods can be effectively carried out only in the absence of chronic changes in the structure of nerve fibers. Thus, conservative treatment methods can be used only if the disease was identified at the initial stage of its development. The main aspect of conservative treatment is wearing orthopedic shoes. Shoes should be as comfortable as possible, have a small stable heel, a wide toe and a loose last. This allows you to unload the foot when moving. In addition, the use of orthopedic metatarsal pads and instep supports is recommended. The symptoms and treatment of a condition such as neuroma are closely related. Considering that even at an early stage of the disease, discomfort and pain may be observed, the following drugs may be prescribed:
In some cases, when treatment with non-steroidal anti-inflammatory drugs does not achieve the desired effect, administration of hormonal drugs in combination with an anesthetic to the neuroma may be indicated. As a rule, with timely detection and full treatment of Morton's neuroma using conservative methods, a pronounced improvement in the condition is observed.
When Morton's neuroma develops, treatment at home with conservative methods is not always possible. In the absence of a pronounced effect during conservative therapy, treatment is carried out using surgical methods.
There are several surgical options for treating Morton's neuroma.
In the vast majority of cases, this benign formation is removed. Considering that this neoplasm is part of a nerve, during the operation the hypertrophied and inflamed area of the nerve ending is simply excised. As a rule, the consequence of such an operation is chronically persistent numbness of the 3rd and 4th fingers, which, however, is not felt by patients until the fingers are touched. If the operation is performed correctly, the function of the fingers is completely preserved, and the ability to move the fingers remains. This type of surgery is performed under local anesthesia. The excised area is sutured. Stitches are usually removed after about 2 weeks.
The second commonly used surgical option for treating a condition called Morton's syndrome is to cut the ligament. In this case, the ligament between the metatarsal bones is dissected. This procedure is low-traumatic and is performed under local anesthesia. After its implementation, the development of chronic numbness is not observed. In some cases, such an operation does not give the desired effect; in the future, repeated surgical intervention may be required, during which radical excision of the neuroma body is performed.
A rarely used type of surgery used to treat Morton's neuroma is 4th metatarsal osteotomy. In this case, an artificial bone fracture and bending is performed. Thus, it is possible to relieve compression of the nerve that has increased in size. This operation is quite low-traumatic, since the procedure is performed under local anesthesia through a 2 mm puncture. To control the correctness of the manipulations, the procedure is performed under X-ray control. In the future, there is no scar at the puncture site that remains after radical excision of the bone. Despite the fact that there are advantages to this method of treating a condition such as Morton's neuroma, it is considered too traumatic, and the recovery time can be about 1 month, since in this case it is necessary to limit the mobility of the limb so that the bones can heal normally .
The surgical treatment option is determined by the doctor individually for each patient. Despite the fact that after the operation the patient can immediately go home, he still needs to adhere to certain precautions. During the first 2 weeks after surgery, it is necessary to limit the time you spend on your feet, as pressure on the foot can cause the sutures to open. The wound must be covered with a sterile bandage during this entire time. After removal of the sutures or plaster, if an osteotomy was performed, the person can lead a normal lifestyle.
Morton's neuroma is an insidious disease that can develop in people leading a completely healthy lifestyle. To prevent the occurrence of this disease, you should protect your legs from injuries and bruises. In addition, it is very important to wear high-quality, comfortable shoes. It is better to leave high-heeled shoes for holidays, and in everyday life give preference to practical options.
It is best to wear orthopedic shoes in everyday life that do not compress and do not overload individual parts of the foot. Among other things, it should be remembered that neuroma of the foot often develops in people suffering from excess weight, so its control is the most important preventive measure.
If there is a history of transverse flatfoot, it is necessary to take measures aimed at its treatment. A particularly important point is to carry out therapeutic exercises for the feet and massage. If you notice the first signs of the development of Morton's neuroma, you should definitely consult a doctor, since in the early stages of the development of this condition it is quite possible to get by with conservative treatment without resorting to surgery.
Morton's neuroma is a benign fibrous formation at the site of the lateral plantar nerve of the foot. It is usually localized on one side, causing a lot of unpleasant sensations. What are the dangers of this disease?
Experts still cannot understand why this disease develops. The most likely cause is compression of the plantar nerve by the bones of the foot. The neuroma always forms between the third and fourth toes - just where the superficial branch of the lateral plantar nerve passes. There are other factors that presumably lead to the formation of neuroma:
The disease most often develops in middle-aged women (this is probably due to improper selection of shoes). Bilateral lesions are very rare. Most often, the tumor is localized on one side, causing serious discomfort to the person. How to recognize this pathology?
Symptoms characteristic of the disease develop gradually. The thickening that forms between the fingers, over time, begins to put pressure on the bones and ligaments located here. At the very beginning of the disease, a person makes many complaints. Numbness, tingling, and burning in the toes are the main symptoms that characterize Morton's neuroma. Over time, a moderate aching pain appears, which intensifies when wearing tight, uncomfortable shoes. Discomfort usually occurs during walking and subsides with rest.
Another characteristic symptom of the disease is the sensation of a foreign body between the third and fourth toes. As the pathology progresses, the pain becomes unbearable, forcing the patient to see a doctor. A distinctive sign of a neuroma is increased pain when the foot is compressed across.
Tip: Have you noticed any symptoms of a tumor? Consult a doctor!
Symptoms alone are not enough to make an accurate diagnosis. There are no visible changes during the formation of neuroma. The formation does not protrude above the surface of the skin, and at first glance nothing special is detected on the foot. After a thorough examination, if Morton's neuroma is suspected, the doctor will definitely send the patient for an X-ray examination. This method not only allows you to see the formation between the third and fourth toes in the image, but also excludes other foot diseases (for example, the consequences of a previous injury or malignant tumors).
If the expected changes cannot be seen on the x-ray, the doctor may suggest that the patient undergo an MRI (magnetic resonance imaging). This method shows the formation of the foot with high accuracy and allows for competent differential diagnosis. In some cases, it is enough to limit yourself to ultrasound examination of the suspicious area.
The disease can be managed using both conservative and surgical methods.
Conservative treatment includes the following procedures:
Anti-inflammatory drugs are widely used to relieve pain. Painkillers are used in tablets provided they are well tolerated and there is no liver disease. A good effect was noticed from physiotherapy (SWT, electrophoresis).
If taking anti-inflammatory drugs in combination with physical therapy does not bring a positive result, doctors inject glucocorticosteroids into the area of the neuroma. This method allows you to quickly relieve pain and swelling and significantly improve the patient's condition.
Advice: when the first signs of illness appear, do not delay visiting a doctor! Timely diagnosis and treatment can avoid surgery.
If conservative therapy does not bring a positive result within 3-4 months, Morton's neuroma should be removed. Classic surgery involves excision of the formation along with the altered portion of the plantar nerve. The recovery period lasts up to 14 days. After surgery, it is recommended to reduce the load on the foot during the entire wound healing period.
The big disadvantage of this treatment method is that after the procedure, numbness of the foot in the area of the neuroma remains (as a result of the removal of a section of the nerve). Many experts consider it inappropriate to carry out such a radical operation. These surgeons suggest cutting the ligament between the bones to relieve pressure on the plantar nerve. After this operation, there is no discomfort in the toes.
Osteotomy of the 4th metatarsal bone is another common method of surgical treatment of neuroma. During surgery, the doctor moves the head of the bone so as to eliminate the compression of the nerve. The procedure is performed through a small puncture, which leaves no scars. The recovery period lasts up to one month.
All operations are performed under local anesthesia. After the procedure, the patient remains under the supervision of a doctor for at least an hour, after which he can go home. Sutures are removed 10-14 days after the procedure. In the first week after surgery, you should reduce the load on the joints of your feet, and be sure to wear comfortable and soft shoes. After the stitches are removed and the wound heals, the patient can return to their normal lifestyle.
If you experience pain in the foot area, you should contact a qualified specialist. Modern medicine offers good methods for getting rid of a disease such as Morton's neuroma. It is only important not to delay the diagnosis and follow all the doctor’s instructions - and then each patient will have a chance to avoid the progression of the disease.
Many people feel pain in their legs after a long walk. Often the cause of discomfort is diseases of the joints or bones, which are provoked by metabolic disorders, injuries or wearing shoes that damage the foot. One of the causes of the malaise is the progression of a rather rare disease - Morton's Neuroma (perineural fibrosis). If pain and a feeling of heaviness are accompanied by numbness of the fingers or even part of the foot, a tingling feeling and the absence of visible deformities , treatment for this particular disease should be started immediately.
Morton's neuromas occur predominantly in women, as well as professional athletes (figure skaters, runners, speed skaters). The cause of pain is compression of the nerve ending located between the third and fourth phalanges of the toes. As a result, a slight burning sensation, tingling, and sometimes severe pain or even a sensation of the presence of a foreign object is felt in the leg. What is important is that in the initial stages of the disease you can get rid of unpleasant sensations by taking off your shoes and massaging the painful area of your foot.
Scientists still haven’t figured out what exactly provokes the development of Morton’s Neuroma, but the main factors that increase the risk of developing the disease are already known:
If the need to treat a neuroma is ignored, the unpleasant symptoms will increase over time, and it will be difficult to get rid of the painful sensations even at rest. Advanced cases of Morton's Neuroma can only be treated surgically, but in the early stages the disease can be effectively managed with conservative treatment (avoiding problematic shoes, using orthopedic insoles, using massage treatments and corticosteroid medications). Traditional recipes also help cure the disease.
Simple home recipes are effective in cases where treatment is in the initial stages of the disease and no significant damage to the foot has occurred. In this case, you can apply one of the following products to the sore spot.
The recipe for treating Morton's Neuroma using vinegar has been known for centuries. It is advisable to use a natural one (apple or wine), half a liter of which is mixed with hot water and used as a foot bath.
A special rub made from ground red pepper, dry mustard and table salt will also help relieve the symptoms All components are mixed in equal quantities, 200 grams are poured. vodka and infuse for a week, shaking occasionally. After straining, the resulting mixture can be used to rub the foot during periods of acute pain.
A decoction prepared from flax seeds can also be used to treat the disease. For 1 liter of water take 4 tbsp. dried seeds, which are boiled on low heat for a quarter of an hour. Next, the resulting broth is cooled and honey or lemon juice is added for taste. You need to drink the medicine half a glass 3 times a day, and continue treatment for at least 14 days.
A decoction of flax seeds should not be taken by people with liver or pancreas diseases.
Home-prepared remedies allow you to cope with the initial forms of Morton's Neuroma in just 1-2 weeks.
to contents ^
During the treatment of Morton's Neuroma, the use of compresses can significantly relieve pain. You can use alcohol-based products (tinctures of propolis, white acacia or marsh cinquefoil stems), as well as completely herbal recipes.
It is easier to prevent the development of Morton's Neuroma than to subsequently cure the disease. By choosing comfortable orthopedic shoes, you can significantly reduce the risk of foot deformation.
If the disease has already begun to progress, then there is definitely no need to delay treatment. In the initial stages, neuroma can be cured with available home remedies, and in advanced cases, only through surgery.
Morton's neuroma, also known as foot neuroma, is a fibrous growth of tissue in the foot in the area of the plantar nerve. This disease is also called neuroma. It is quite rare. It is most often diagnosed in women after 50 years of age, while men suffer from neuroma much less frequently. On the foot there is an overgrowth between the third and fourth toes. Often the nerve is damaged on one side, but there are also cases of bilateral damage.
Not all factors that lead to the development of Morton's disease have been discovered. The main cause of neuroma is the preference for tight shoes and too high heels, that is, heavy load on the legs. Shoes with low heels, but with too narrow soles, can also lead to the formation of the disease. The following factors are also reasons:
All of the above nuances negatively affect the nerve endings of the fingers, and as a result of the response, a thickening of the nerve sheath appears. Outwardly, a foot neuroma will not be noticeable at all; even the doctor may make a mistake during the first consultation and make an incorrect diagnosis. The main symptom of the disease is discomfort during pressure between the fingers in the transverse direction. The main signs are the following symptoms:
But all these sensations can sometimes subside, and the disease will not show signs at all. Sometimes the absence of symptoms can last for several years. An exacerbation of the disease occurs when wearing narrow and tight shoes. Acute pain will only be felt while walking, and when you take off your shoes and massage your foot, it will subside.
The disease at the last stage is characterized by pronounced symptoms. The patient will feel a constant sharp pain and burning sensation that will not subside even for a couple of hours. Regardless of the type of shoe or heel height, you will still experience pain between the 3rd and 4th toes. Often, patients come to the doctor at the last stage of the disease, when conservative treatment no longer helps.
Patients who discover symptoms of the disease can consult a neurologist, orthopedist, traumatologist, or for a long time. The diagnosis is made based on research. It is important not to delay going to the doctor, otherwise the disease will progress.
For diagnosis, an x-ray of the foot is used, which will help identify longitudinal-transverse flatfoot. But radiography, as well as CT scan of the foot, does not make it possible to determine the presence of a neuroma.
During an MRI, Morton's disease is detected by an area of high signal intensity. The best method for diagnosing the disease is ultrasound in the suspected area of the disease.
Diagnosis of Morton's syndrome occurs in several stages, presented in the table.
Not only diseases of bones, muscles, ligaments and tendons, but also diseases of the digital nerves, which are rare diagnoses, can interfere with walking. With constant compression of the interdigital nerves (between the 3rd and 4th fingers), a disease called foot neuroma (Morton's) occurs, the characteristic symptoms of which are severe pain and numbness. Despite the fact that the causes of this condition are not fully understood, when Morton's neuroma is diagnosed, treatment is conservative and is effective if the patient is treated early.
The disease received its name in honor of the American orthopedic doctor T. Morton, who described its symptoms in 1876. Judging by the ending of the word “neuroma,” you might think that this is a tumor formation, but this is not the case. To understand the mechanism of development of the disease, you need to highlight how the nerves of the foot are located or take a brief excursion into its anatomy.
The nerves in the metatarsal bones have 5 branches, each of which goes further between the toes and ends at their ends. Thus, each branch of the nerve, passing between the fingers, innervates the sides of adjacent phalanges and half of the finger. Normally, the nerves should not be compressed or flattened between the phalanges, but in some cases they become injured, swell, or become fibrotic. Because the nerves run in the narrow space between the fingers, this condition is sometimes called tunnel neuropathy. The consequence of such pathological changes is a flow of pain impulses that are sent to the central nervous system.
The exact causes of the disease have not been studied, but it has been proven that a number of factors can trigger the appearance of the first signs.
All these factors cause injury to the foot and its flatness, in which the nerve fibers locally thicken, and without timely treatment, sclerotic changes develop in the ligamentous apparatus of the toe flexors. Differential diagnosis of Morton's neuroma with other foot diseases is carried out when the first signs appear.
How to treat Morton's neuroma? This is usually done by a neurologist, but with the obligatory consultation of an orthopedist. The main condition and criterion for choosing a treatment method is the elimination of all risk factors and possible causes of the disease. You cannot wear narrow shoes with high heels, be overweight and treat the disease at the same time.
Conservative treatment of Morton's neuroma includes the following steps:
If conservative measures have no effect, and the pain becomes persistent and constant, surgical treatment is resorted to. The tactic of the operation is to widen the canal for the passage of the nerve. If the canal cannot be widened, then surgery for Morton's neuroma involves cutting the metatarsal ligament (ligament release) or removing damaged nerve fibers. Along with the damaged nerve, altered tissues of the ligamentous apparatus are often removed. The only inconvenience after the operation is the lack of sensitivity between those phalanges of the fingers where the nerve was removed.
Preventing a disease is easier than treating it. Prevention measures become especially relevant after conservative and surgical treatment of Morton's neuroma. It is necessary to wear comfortable shoes, diagnose flat feet in a timely manner and carry out its correction, as well as eliminate other factors that can cause nerve pinching.
The disease responds well to conservative therapy in the initial stage, when irreversible processes in the form of fibrous growth of the nerve have not occurred. Therefore, if you suspect pinched nerve fibers, you should consult a doctor and carry out the necessary treatment for Morton's neuroma.