Morton’s Neuroma

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Morton’s neuroma is a disease that can be debilitating due to its easy chronic condition and its pain that is difficult to resolve. Nervenia operators recommend not to neglect this problem in the early stages because it is precisely at this stage that non-invasive therapies can be decisive.

Definition

Morton’s neuroma is defined as the increase in fibrotic volume of an interdigital sensory nerve in the foot. The first official description took place in Philadelphia in 1876, although there are already reports of this pathology at the beginning of the nineteenth century in the English court and in Italy.

Causes

The direct cause of Morton’s neuroma is metatarsalgia, anterior plantar pain of the foot. Repeated and prolonged inflammation of this part also involves the area of  passage of these nerves, which through a defense process form a sort of fibrous “callus” which determines the formation of the so-called neuroma. Matatarsalgia can be caused by:

  • a foot rest that overloads the front part too much with respect to the back,
  • particular altered foot supports,
  • repeated work and sports microtraumas,
  • postural imbalances,
  • inadequate footwear with a narrow forefoot, high heels and a stiff sole.

Symptoms

Morton’s neuroma gives a often very strong neuralgic pain, with electric shocks and burning on the toes, with the urgent need to remove the shoes if they are tight or with high heels. Obviously, being a problem of support, walking or standing make it worse; however, it is not uncommon for symptoms in later stages to be present even at rest with paraesthesia, numbness and decreased sensitivity in the fingers.

Diagnosis

The diagnosis of Morton’s neuroma is essentially clinical, that is based on the patient’s symptoms, as it is unlikely that the neuroma is accompanied by a visible swelling in the intermetatarsal space. Often a click is felt during palpation (Mulder sign) . If surgery is considered useful, the specialist often completes the diagnosis with an ultrasound or an MRI, although these tests sometimes give false positive results.

Cures and remedies

First of all it is advisable to use orthotics, whatever the cause. In fact, if the plantar support is not corrected immediately, no therapy will be successful.

In the initial stages of the problem, various therapies are performed, for example:

  • analgesic physiotherapy, to reduce internal pain and swelling
  • infiltrative therapy with cortisone and / or local anesthetics.

In more advanced stages surgery may be necessary. Surgery involves the removal of Morton’s neuroma.

Nervenia treatment is applicable to any phase of Morton’s neuroma.

In fact, it is recommended in case of:

  • conservative therapy, combined with analgesic physiotherapy or infiltration, as deep nerve stimulation (DNS) with neuromodulation works by restoring proper nerve function and reducing inflammation, which is the cause of the problem;
  • preparation for surgery, as this will remove the swelling and the risk of complications;
  • post-surgery as neuromodulation becomes essential to stimulate the nerve to function properly and prevent the surgical scar from be coming a new source of irritation.