Mortons Neuroma Surgery

Overview
This is a painful condition affecting a small nerve in the foot. It occurs when the five How long do you grow during puberty? bones that run the length of the foot get pushed together, pinching the nerve in between. This friction on the nerve causes it to thicken and inflame causing pain. The condition gets its name from an American surgeon, George Morton.

Causes
The exact cause is as yet unclear. However there are a number of theories. Some expert s believe problems with the design of the foot makes some people more prone to Morton?s neuroma. Having flat feet or a high arch for example encourages the foot to slide forwards which can put excess pressure on the metatarsals. Bunions and hammer toes also increase the likelihood of developing Morton?s. However simply wearing high heels or any form of tight shoes that put pressure on the bones in the feet can also lead to a Morton?s . Typically the condition comes on between the age of 40 and 50. It is far more common in women than men - three out of four sufferers are women.

Symptoms
Neuroma patients occasionally complain of a ?pins and needles? sensation that spreads through their feet, or of a feeling akin to hitting their ?funny bone.? The sensation may be described as similar to an electric shock. Some patients also say that these symptoms, as well as those listed above, will come and go, depending on what they are wearing on their feet, the activity they are doing, or on other external factors.

Diagnosis
Morton?s neuroma can be identified during a physical exam, after pressing on the bottom of the foot. This maneuver usually reproduces the patient?s pain. MRI and ultrasound are imaging studiesthat can demonstrate the presence of the neuroma. An x-ray may also be ordered to make sure no other issues exist in the foot. A local anesthetic injection along the neuroma may temporarily abolish the pain, and help confirm the diagnosis.

Non Surgical Treatment
Conservative treatment involves a reduction in the inflammation and removing the impingement factor. Reduction in inflammation is achieved via rest, elevation, ice, and massage with anti-inflammatory gels. Removing foot wear and and/r wearing broad type footwear would also help. Injection therapy is useful in reducing symptoms but not very successful in providing long term relief. The only time when it is most appropriate is when the cause of the space occupying object is not a neuroma but an inflamed bursa. Injection would help to relieve symptoms, and often cortisone is not even necessary.

Surgical Treatment
If pain persists with conservative care, surgery may be an appropriate option. The common digitial nerve is cut and the Mortons neuroma removed. This will result is numbness along the inside of the toes affected, and there is a small chance the end of the nerve will form a Stump Neuroma. Approximately 75% of people receive symptom resolution for Mortons Neuroma with conservative care.

Prevention
Women, particularly those who wear tight shoes, are at greatest risk for Morton?s neuroma. The best way to prevent the condition is to wear shoes with wide toe boxes. Tight, pointed shoes squeeze bones, ligaments, muscles and nerves. High heels may worsen the problem by shifting your weight forward. Over time, this combination can cause the nerves to swell and become painful.