mortonsneuroma

… also known as intermetatarsal neuroma, is a condition where there is a neuroma between the metatarsals of your foot, near the balls of your feet or your “fore foot”. A neuroma is a benign growth of nerve tissues that can cause burning pain, numbness, and tingling. The cause of Morton’s neuroma is often tight shoes and hypertonic muscles in the foot overtime. Hypertonic muscles describe muscles that do not know how to relax – they are in a constant state of “high tone”. As a result, the muscles pinch nerves and blood vessels in the area. Nerves will start to thicken its surrounding sheath (akin to a coffee cozy for a cup of coffee) to protect itself. Overtime, the tissue hardens and a neuroma is formed. Muscles that affect Morton’s neuroma most commonly are lumbricals or interossei muscles that are located in between the metatarsals.              

People with Morton’s neuroma would feel discomfort in their forefoot between the foot arch and the toes. Most common area is between the third and fourth toes. Early signs include discomfort or pain when wearing narrow footwear, but better when barefooted or after massaging your foot. Burning sensations and pain when you squeeze your feet are also signs of this condition. You may also feel like something is in your shoe or your sock bunching up in the ball of your foot when you walk. Overtime, the condition progresses to the point where pain is present constantly, even when you’re barefooted. Diagnosis is as simple as getting a diagnostic ultrasound done for your affected foot.

As for treatment, the key is early diagnosis and treatment prior to the neuroma solidifying into somewhat of a “callus”. Myofascial release and soft tissue therapy to the involved muscles as well as acupuncture to the neuroma has been shown to reduce symptoms. Strong intrinsic foot muscles will aid in the release of hypertonic muscles. Avoiding narrow footwear such as high heels and aggravating activities are important to reduce further irritation to the nerves in the foot. Orthotics with padding can be used to further minimize repetitive pressure on the neuroma when you’re on your feet all day.

If conservative treatment does not improve your symptoms, your doctor may suggest a cortisone injection into the neuroma. If no relief is found with cortisone, your doctor may refer you to a foot specialist for a consultation on possible surgery to resect a section of your nerve or to release the surrounding soft tissue to make more room for the neuroma. Most of the time, a change to proper footwear and conservative treatments are enough to minimize discomfort and pain caused by Morton’s neuroma.

If you have any questions or think you may have the inklings of a Morton’s neuroma, feel free to contact one of our practitioners for a free 15-minute consultation.

 

Written By: Danette Lam, MScPT

  • Vishal Patel

    Vishal Patel is a registered physiotherapist in good standing with the College of Physiotherapists of Ontario, Canada. After completing his bachelor’s degree in Physiotherapy from India in 2008, he worked in orthopedic and spine surgery hospital as a clinical physiotherapist. Believing strongly in continuing education, he went to England in 2009 to pursue his master’s degree from Sheffield Hallam University, where he specialized in orthopedic physiotherapy field. While pursuing post graduate studies, he developed thorough knowledge in evidence-based practice and importance of research into routine clinical practice. He strongly believes in hands on approach and uses variety of manual therapy skills including joint mobilizations, soft tissue release, cupping therapy, exercises prescription while rendering physiotherapy treatment to his patients. His clinical expertise includes treating various musculoskeletal conditions, pre & post-operative orthopedic surgeries and sports related injuries, TMJ dysfunctions and concussion rehabilitation. He is rostered with The College of Physiotherapists of Ontario to perform acupuncture and dry needling. As a part of continuous professional development, he is planning to take on courses on orthopedic manipulative techniques, and vestibular rehabilitation to further enhance his skills.

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