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What Causes Mortons Neuroma
29.05.2017 12:25
Overview

interdigital neuromaA Morton's neuroma usually develops between the third and fourth toes. Less commonly, it develops between the second and third toes. Other locations are rare. It also is rare for a Morton's neuroma to develop in both feet at the same time. The condition is much more common in women than men, probably as a result of wearing high-heeled, narrow-toed shoes. This style of shoe tends to shift the bones of the feet into an abnormal position, which increases the risk that a neuroma will form. Being overweight also increases the risk of a Morton's neuroma.

Causes

Morton's Neuroma is a caused by pressure, abnormal function/motion or an imbalance in the structure of the foot such as flat feet, that causes an abnormal pressure on the structures and the nerves in the ball of the foot. It most commonly affects the nerve that goes to the 2nd 3rd or 4th toes. The squeezing of the nerve from abnormal motion leads to a protective thickening of the sheath that protects the nerve. Symptoms of Morton's Neuroma often occur during or after activities that cause a sidewards squeezing of the ball of the foot or from pressure such as walking, standing, or playing sport. Since squeezing is a common cause of the condition, shoes such as pointed toes or high heels can often lead to a neuroma. Shoes that are constricting, even tight sneakers, can pinch the nerve between the toes, causing inflammation and pain.

Symptoms

People with Morton's neuroma usually complain of pain that can start in the ball of the foot and shoot into the affected toes. However, some people just have toe pain. There may also be burning and tingling of the toes. The symptoms are usually felt up the sides of the space between two toes. For example, if the nerve between the third and fourth long bones (metatarsals) of the right foot is affected, the symptoms will usually be felt up the right-hand side of the fourth toe and up the left-hand side of the third toe. Some people describe the pain that they feel as being like walking on a stone or a marble. Symptoms can be made worse if you wear high-heeled shoes. The pain is relieved by taking your shoe off, resting your foot and massaging the area. You may also experience some numbness between the affected toes. Your affected toes may also appear to be spread apart, which doctors refer to as the 'V sign'. The symptoms can vary and may come and go over a number of years. For example, some people may experience two attacks of pain in a week and then nothing for a year. Others may have regular and persistent (chronic) pain.

Diagnosis

If you suspect Morton?s Neuroma, it is essential that you confirm your suspicions by consulting with a podiatric physician. Don?t wait for the symptoms to go away for good (even if they tend to come and go). Also, remember that many conditions have similar symptoms, and only a professional can tell the difference.

Non Surgical Treatment

The good news is that the pain can often be relieved fairly easily with the right softer styled orthotic (even in those cases where there is concurrent plantar plate tears and capsulitis!), but its important to remeber that even if your no longer in pain, there is no magic cure to speeding up the healing process so one must take care of their feet for 6-12 weeks. As a rule of thumb a neuroma should always be treated conservatively where possible. This means icing and resting the area, trying to remove the causative factors, and providing postural control and support via metatarsal domes or, if needed, specialised pre-made or custom made orthotics.Morton neuroma

Surgical Treatment

When conservative measures are unsuccessful, surgery can be a good choice in the treatment of Morton's neuroma. The operation for Morton's neuroma does not require an overnight hospital stay. The anesthetic used is an ankle block, which completely numbs the foot during the surgery. The physician removes the neuroma from an incision made on the top of the foot between the involved metatarsal heads. The nerve to the interspace is exposed and cut next to the metatarsal heads.

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