A neuroma is a thickening or enlargement of nerve tissue, which is often caused by irritation or compression of a nerve. This type of neuroma usually occurs at the base of the third and fourth toes.
If you have a Morton's neuroma, sharp or dull pain is usually felt between the third and fourth toes. This can be made worse by wearing tight shoes and by walking. You may feel numbness, tingling, or a burning sensation around the area. Symptoms can come on very quickly or gradually over a period of time and tend to worsen.
There are a number of factors that can contribute to a neuroma being formed. High heeled shoes with a constricted toe box can cause compression of the nerve. The condition is more common in women as a result of wearing such shoes. Conditions such as a high arch or a low arch foot or a hammer toe can lead to a neuroma. This is due to the instability of the structures around the toe. Sports which have a repetitive force on the front part of the foot (forefoot) can also cause a neuroma.
An assessment with a podiatrist is recommended to diagnose the problem and find its cause. Questions regarding levels of pain and what activity worsens it will be asked. In the meantime, wearing supportive footwear with enough width is advisable.
This condition can worsen over time. Continuing to wear unsuitable footwear will worsen the problem, as will partaking in sports that place significant stress on the forefoot. Treating any other problems that may be causing the neuroma is essential, for example a low arched foot may require an insole or orthotic.
Early conservative treatment is preferred for this condition, though if this isn't possible, some people require surgical removal of the enlarged nerve.
The aim of podiatry treatment for a Morton's neuroma is to reduce and relieve pressure around the nerve. This can be done in a number of ways, starting with wearing a flat, wide lace-up shoe. Orthotics are the next option. Orthotics are shoe inserts which help improve foot function and therefore reduce pressure around the nerve. Padding can be useful under the forefoot to provide comfort and relieve pain.
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