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If you
sometimes feel that you are "walking on a marble,"
and you have persistent pain in the ball of your
foot, you may have a condition called Morton’s neuroma.
A neuroma is a benign tumor of a nerve. Morton’s
neuroma is not actually a tumor, but a thickening
of the tissue that surrounds the digital nerve leading
to the toes. It occurs as the nerve passes under
the ligament connecting the toe bones (metatarsals)
in the forefoot. Morton’s neuroma most frequently
develops between the third and fourth toes, usually
in response to irritation, trauma or excessive pressure.
The incidence of Morton’s neuroma is 8 to 10 times
greater in women than in men.
Signs
and Symptoms
Normally, there are no outward signs, such as a
lump, because this is not really a tumor. The chief
complaint is usually burning pain in the ball of
the foot that radiates into the toes. The pain generally
intensifies with activity or wearing shoes. Night
pain is rare. There may also be numbness in the
toes, or an unpleasant feeling in the toes. Runners
may feel pain as they push off from the starting
block. High-heeled shoes, which put the foot in
a similar position to the push-off, can also aggravate
the condition. Tight, narrow shoes also aggravate
this condition by compressing the toe bones and
pinching the nerve.
Diagnosis
and Treatment
During the examination, your physician will feel
for a palpable mass or a "click" between the bones.
They will put pressure on the spaces between the
toe bones to try to replicate the pain and look
for calluses or evidence of stress fractures in
the bones that might be the cause of the pain. Range
of motion tests will rule out arthritis or joint
inflammations. X-rays may be required to rule out
a stress fracture or arthritis of the joints that
join the toes to the foot.
Initial
therapies are nonsurgical and relatively simple.
They can involve one or more of the following treatments: |
