CAUSES OF MORTON'S NEUROMA:
1) - High Heeled Narrow Shoes - narrow shoes cause external compression to the intermetatarsal nerves. Runners and bicyclists may experience symptoms late in a run or bike because the foot swells - resulting in a tighter shoe. This is called transient forefoot compression neuropathy. Walking barefoot or in shoes with thin leather soles also causes external compression to the nerves.
2) Foot Deformities - bunions, hammertoes, flat feet or overly flexible feet may predispose patients to neuroma formation.
3) Certain Sports - high impact sports such as running and court sports subject the feet to repetitive trauma. Sports that require tight shoes such as skiing put pressure on the foot.
Treatment for neuromas includes roomier shoes, icing the foot twice a day, metatarsal padding, anti-inflammatory medication, and sclerosing alcohol injections (a diluted alcohol solution is injected that shrinks the neuroma). These injections have a high success rate - significantly higher than cortisone injections, though recurring flare ups are not uncommon.
Many patients require a custom foot insert, called an orthotic, to avoid surgical treatment of the neuroma. Orthotics are designed to reduce the abnormal internal forces acting on the nerve during weightbearing activities.
In the event that conservative measures don't relieve the symptoms, surgical correction is indicated. Traditional neuroma surgery included an incision on the top of the foot and removal of the enlarged nerve tissue. These neurectomies sometimes resulted in permanent numbness or pain associated with excision of the nerve.
A more modern, sophisticated procedure, Decompression Surgery, involves cutting a tight ligament that relieves the pressure on the nerve/neuroma. This allows for an extremely small, virtually invisible incision and avoids damaging the nerve directly. Subsequently, there are less complications than with traditional neuroma surgery. Recovery time is less, walking is allowed immediately and there is less risk of scar tissue.
If you are experiencing any of the symptoms mentioned above, do not hesitate to call us today for a consultation.
Sincerely,
Dr. Jay Kerner
Dr. Daniel Zilberbrand
