Morton's neuroma [symptoms, treatment and removal]

What is Morton's neuroma disease?

The tendency to develop foot pathology among modern patients is explained by the increased load on this anatomical formation. It consists of muscles, joints, ligaments, bones and the neurovascular system, which must function as a single system when a person performs various movements.

If the functionality of the foot is impaired, we can talk about Morton's neuroma, a disease characterized by the appearance of a benign formation between the tarsal phalanges of the third and fourth toes. This thickening is localized at the level of the nerve passage and has an elongated shape. On average, the width of an interdigital neuroma can reach 0.15-0.50 cm, and its length - 0.95-1.40 cm. In essence, this is one of the signs of tunnel syndrome of the interdigital nerve of the foot, which is one of the pathologies of the peripheral nervous system . The key factor provoking the disease is considered to be repeated microtraumas and compression disorders in the nerve area.

As a rule, women in the age group from 35 to 60 years are susceptible to this pathological process. Moreover, the formation is always localized on one foot.

Morton's neuroma - what is it? Symptoms, diagnosis and treatment

Morton's neuroma is a specific foot disease. It is a benign thickening and occurs as a result of the proliferation of fibrous tissue. This occurs in the area of the plantar nerve of the foot. As a result, the bones and ligaments located next to the nerve begin to compress it. Generally, this tumor appears between the 3rd and 4th toes, in an area called the third intermetatarsal space. Very rarely, a neuroma can be found in another place - between the 2nd and 3rd fingers. Another characteristic of this disease is that it almost always occurs on only one foot. In most cases, nerve damage in neuroma is unilateral. Bilateral is very rare. Morton's neuroma may have other names. These are foot neuroma, interdigital neuroma, Morton's finger syndrome, Morton's syndrome, perineural fibrosis and intermetatarsal neuroma.

This pathology occurs most often in women older than middle age.

Causes leading to the appearance of the disease

There are several reasons that contribute to the appearance of Morton's neuroma. Among them:

Wearing tight and narrow shoes, as well as high-heeled shoes;
Excess body weight;
Transverse flatfoot;
Mechanical impact when the nerve is compressed by the bones of the metatarsus;
Increased loads experienced by the forefoot. Occurs when a person has to stand for a long time;
Various infections, hematomas and other foot injuries.

Symptoms of the disease

Morton's neuroma may have no visual signs in its early stages. The main symptom of the presence of pathology is pain that occurs when the forefoot is compressed transversely. The patient may complain of numbness in the toes, aching pain, and a feeling that there is a foreign object between the toes. All these symptoms are not pronounced, and the disease itself is sluggish. This may continue for several years. Exacerbations of the disease occur when wearing tight and narrow shoes. The pain appears while walking and subsides if you take off your shoes and massage the foot.

When the disease enters its final stage, the pain becomes severe and shooting. Now it appears regardless of shoes and load size. Every year the pain becomes stronger.

Diagnosis of Morton's neuroma

Diagnosis of the disease takes place in several stages. First, anamnesis is collected and the patient is interviewed. The doctor should listen to the patient's complaints and also find out what type of shoes he wears. In order to establish the possible cause of the disease, the doctor collects information about what leg diseases the patient has had in the past. These can be muscle diseases, arthritis and various types of injuries.

The doctor then palpates the foot by applying pressure with their fingers to find out where the pain or numbness is. In cases where diagnosis is difficult, an x-ray or MRI may be taken. To determine the location of the neuroma, a method such as the administration of anesthetics is used.

Treatment methods

Treatment of Morton's neuroma is carried out in two ways - conservative and surgical. Conservative treatment is usually used at the onset of the disease. All measures and procedures of this method serve to eliminate unnecessary pressure on the nerve area. In this case, shoes must be replaced. It should be loose and comfortable, with low heels. The best option is special orthopedic shoes. A pad should be used where the foot is compressed. Patients also need to systematically undergo physiotherapeutic procedures.

To relieve pain and inflammation, the patient is usually prescribed non-steroidal anti-inflammatory drugs. This may be ibuprofen, indomethacin or others. If this treatment is ineffective, you can try other drugs - steroids. Together with an anesthetic, they are injected directly into the area of the neuroma. Drugs such as hydrocortisone, Kenalog or Diprospan may be used. Typically, conservative treatment is successful in 80% of cases.

If conservative treatment does not give the desired result, surgical intervention is used. This procedure is done under local anesthesia. During it, the metatarsal canal must be opened, and then the neuroma itself must be dissected. Part of the nerve may also be removed. Often this surgery can cause numbness in part of the foot, which is temporary. After the operation, during the rehabilitation period, which lasts approximately 2 weeks, you should wear orthopedic shoes. The forefoot should be provided with the highest possible level of rest. You can walk the very next day after surgery, but the walking should not be long.

Possible consequences that the disease can lead to

If a progressive neuroma is not treated, the consequences can be very disappointing. This is the continued growth of the tumor, increasing discomfort and pain in the foot. Without treatment, physical activity such as running or dancing becomes impossible. You can also forget about sports.

If you feel the slightest pain or discomfort in the forefoot, contact a specialist immediately. If Morton's neuroma is detected, treatment should begin immediately. We remind you that wearing correctly selected orthopedic shoes is the most important component of such treatment.

Causes of Morton's neuroma formation

In the development of foot neuroma, both endogenous factors and genetic causes are of key importance. The etiological factors involved in the formation of carpal tunnel syndrome include: excessive load on the front of the foot associated with frequent wearing of high-heeled/flat shoes or tight shoes; the presence of hematomas in the area where the nerve is located; flat feet; traumatic lesions of the feet (fractures, bruises); overweight; long walking; various pathological processes in the vascular area; infectious diseases; the presence of benign tumors in the foot area, etc.

Causes of Morton's neuroma development

First of all, these are valgus and varus deformities of the foot, primarily the presence of flat feet.
Incorrect selection of shoes, for example, too narrow shoes or too high a heel, or, on the contrary, a complete lack of heels - too flat a sole.
Frequent foot injuries (professional athletes of certain sports fall into this risk group).
Overweight, obesity.
Forced standing for long periods of time (the risk group includes people in certain professions whose specific work requires prolonged walking or standing).
Chronic inflammatory diseases of the feet, such as bursitis, tendovaginitis, arthritis, etc.

Symptoms of Morton's neuroma

Most often, with interdigital neuroma, the patient notes pain. Their intensity and nature are directly related to the size of the formation and its location. At the first signs of the disease, slight itching or a slightly noticeable tingling sensation occurs. Similar symptoms are observed after prolonged standing or increased physical activity. To eliminate discomfort, a night's rest is enough for the patient.

As tunnel neuropathy develops, the pain intensity increases and the toes begin to lose sensation. Over time, the patient indicates a feeling of discomfort in the area between the 3rd and 4th toes, which eliminates the possibility of wearing shoes comfortably.

In advanced stages, the pain syndrome becomes continuous and intense, a person’s gait changes, and other serious complications appear that can impair motor activity.

Symptoms

In the early stages, it is difficult to accurately diagnose this disease. It has no external signs and can be manifested by the following symptoms:

numbness and pain in the toes;
aching pain in the forefoot;
burning and tingling at the base of 3-4 fingers;
discomfort when walking, especially in high heels;
sensation of a foreign body in the forefoot.

The pain may intensify when wearing tight shoes, but it may also subside and not bother you even for several years. However, sooner or later the disease will make itself known. Over time, symptoms may worsen, and the sensation of a foreign body at the site of formation may become more pronounced.

In the later stages, inflammation can be felt by pressing transversely on the foot.

Only a highly qualified specialist can correctly diagnose Morton's neuroma in the early stages.

Diagnosis of Morton's neuroma

Morton's disease manifests itself against the background of inflammation, and not a malignant process in the tissues. To make an accurate diagnosis, the doctor asks the patient questions regarding the nature and moment of the onset of discomfort. During the appointment, the specialist examines the shape and outline of the foot, and also pays attention to the presence of anatomical changes. Next, he performs a frontal compression. If the patient notices increased pain in the midfoot area, this sign is characteristic of tunnel neuropathy.

In addition to examining the patient, the following diagnostic measures must be performed:

X-ray. Allows you to identify the presence of various changes resulting from injury to the foot, as well as judge the development of degenerative processes and deformation of bone tissue;
MRI is additionally prescribed . It is carried out if after the x-ray the doctor still has doubts about the diagnosis. Based on this method, it is possible to identify the presence of local compaction in the intermetatarsal region;
Morton's neuroma can be diagnosed by ultrasound . At the same time, it is possible to monitor blood flow and the condition of soft tissues;
Biopsy. Allows one to judge the presence of a formation under the ligament.

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Clinic on Krasnopresnenskaya +7 (499) 252-41-35 Volkov lane, 21
Clinic on Varshavskaya +7 (499) 610-02-09 Varshavskoe highway, 75, building 1
Clinic in Annino +7 (495) 388-08-08 Varshavskoe highway, 154, building 1

How to treat Morton's neuroma of the foot?

If a patient is diagnosed with Morton's neuroma, treatment begins with reducing the weight on the foot. This is required to slow down the destructive process and prevent pain. As a first step, experts advise purchasing more spacious shoes with heels up to 4 cm or starting to wear an orthopedic model.

Also, for Morton's neuroma, you can use orthopedic insoles , which allow you to restore the optimal position of the transverse arch of the foot. As an additional device, it is recommended to use special pad inserts, which are placed at the base of the metatarsal bones.

If a patient is diagnosed with Morton's neuroma, timely measures can achieve the following effects:

Minimize the load on the front of the foot and restore the optimal position of the transverse arch;
Reduce the pressure of ligaments and bones on the nerve;
Restore biomechanical functions;
Stop inflammation near the nerve.

Use of medications

In combination with the use of orthopedic devices, Morton's neuroma can be treated with medications:

In case of a painful attack of increased intensity, the hormonal drug Diprospan or the potent painkiller Novocain are prescribed. The above medications must be used monthly;
To relieve inflammatory manifestations and eliminate pain, steroid hormones from the subclass of corticosteroids are often prescribed, which are injected into the affected area;
For pain of moderate intensity, it is recommended to use Baralgin, Nurofen and Ketoprofen;
To eliminate muscle spasms, the muscle relaxants Mydocalm and Sirdalud are used.

To obtain a prolonged positive effect from the use of the above drugs, they must be used for at least three months.

Physiotherapy for Morton's disease

For Morton's neuroma, additional treatment involving the use of physiotherapeutic procedures is prescribed. Due to this, it is possible to increase the effectiveness of the use of drugs, as well as improve metabolic processes in the affected area.

So, for tunnel neuropathy, it is advisable to perform the following procedures:

Effect on the body of an alternating magnetic field;
Exposure to shock waves;
The use of needles inserted into acupuncture points;
Exposure of the body to direct electric current simultaneously with the introduction of special medicinal compounds through the skin;
Massotherapy. It is carried out starting from the ankle and ending with the fingertips.

In some situations, there are restrictions on the use of physiotherapeutic methods. These include:

Presence of wounds on the skin;
Pustular skin lesions;
Pathologies of the circulatory system;
Formations of a malignant nature;
Cardiovascular failure.

Use of shockwave therapy for Morton's neuroma

As stated earlier, treatment of Morton's neuroma in Moscow begins with the use of special orthopedic devices. These include insoles, which play a key role in Morton's neuroma, as they allow you to restore the optimal position of the transverse arch of the foot. The patient is also recommended to use non-steroidal anti-inflammatory drugs, injections with steroid hormones, and painkillers.

If conservative methods do not give the desired effect, experts recommend removing Morton's neuroma. However, not all patients with this pathology undergo surgical intervention.

A more gentle and effective way to eliminate the disease is considered to be the SWT , which gives an excellent effect for Morton's neuroma - it improves blood flow in the affected area.

The technique is based on the use of shock waves that affect the nerve trunk. This provides the necessary analgesic effect, helps eliminate the inflammatory process and helps normalize restoration processes in tissues.

The advantages of the procedure also include:

Increased comfort for the patient;
Safety;
Non-invasive nature;
Quickly achieve the desired result.

In our medical]SWT[/anchor] technique is a priority way to eliminate neuroma. The use of innovative Swiss equipment, an individual approach to the problem and the high professionalism of doctors make it possible to obtain maximum efficiency in its implementation.

Removal of Morton's neuroma

If there is no positive result from conservative methods, the doctor refers the patient to surgery.

Today, the following methods are known for surgical removal of compaction in the area of the frontal part of the foot. These include:

Resection of the formation. In this case, a small incision is made in the intermetatarsal area and the seal is completely removed. After this, suturing is performed. At the same time, there is no need to implement measures to ensure foot immobility;
Dissection. It is considered more gentle. In this method, the affected ligament is divided into fibers, which eliminates nerve compression;
Using a surgical laser. This procedure is famous for its low trauma and does not limit the patient’s motor activity in the future;
Radiofrequency catheter ablation. The method is minimally invasive. For Morton's neuroma, it is carried out in combination with ultrasound diagnostics . In this case, the seal is destroyed when exposed to electric current;
Shift of the fourth metatarsal bone. Performed in isolated situations. Using a similar procedure, it is possible to eliminate compression of the nerve. If a patient is diagnosed with Morton's neuroma, bone displacement surgery and subsequent rehabilitation are carried out under x-ray guidance.

By contacting us about seal removal, you will receive a guarantee of a safe and accurate surgical intervention, as well as quick and easy rehabilitation after it. This is due to the presence of highly qualified surgeons in the state, who have hundreds of similar operations behind them.

Treatment of Morton's neuroma with traditional methods at home

Despite the proven effectiveness of the above methods for Morton's neuroma, many patients are interested in how to treat the pathology at home . Their effectiveness with the right approach has also been confirmed. But resorting to these methods is recommended in exceptional situations, with mild forms of the disease. Below we will talk about the most effective of them:

A bandage on the sore spot, moistened with an infusion of wormwood;
Burdock root infusion;
Kalanchoe juice;
Flax seed infusion;
A cabbage leaf that is applied to the affected area;
Dress with an ointment made from lard and baking soda;
Compress with ointment obtained from laurel leaves (2 tablespoons), pine needles (1 tablespoon) and butter (50 g);
A bandage soaked in a mixture of sunflower oil, mustard and honey.

With the right approach, the above remedies can be quite effective.

Make an appointment Online booking

Clinic on Krasnopresnenskaya +7 (499) 252-41-35 Volkov lane, 21
Clinic on Varshavskaya +7 (499) 610-02-09 Varshavskoe highway, 75, building 1
Clinic in Annino +7 (495) 388-08-08 Varshavskoe highway, 154, building 1

Treatment of Morton's neuroma

In order to begin treatment, it is necessary to establish an accurate diagnosis. In the case of neuroma, the main points for making a diagnosis are examination by a specialist (traumatologist-otopedist, neurologist) and ultrasound of the soft tissues of the foot. If diagnosed early, treatment should begin immediately. With the initial stages of the disease and timely treatment, the prognosis is quite favorable. In the treatment of neuroma, several basic methods are used, when combined, the effect is achieved faster and more reliably.

The first and one of the most important points in treatment is the correct selection of shoes and constant wearing of individual orthopedic insoles. As for shoes, they should not be shoes with a narrow toe, squeezing the toes, also not too high a heel and not completely flat soles. The ideal is a low, stable heel and a wide toe of the shoe. In turn, in addition to properly selected shoes, orthopedic insoles unload the feet, remove the load from the vulnerable area, bring the foot into the correct position, which together immediately brings results, primarily in reducing the intensity of pain.

In addition to shoes and orthopedic insoles, methods such as physiotherapeutic procedures, massage, and medicinal applications are used in the treatment of neuroma.

It is also recommended to reduce the load on the affected foot during treatment. And lose excess weight, if any.

If pain is severe, you may need to take additional non-steroidal anti-inflammatory drugs (after consultation with a specialist). Also, the doctor, if necessary, may prescribe a course of hormone therapy. The average course of treatment takes about 3 months, after which pain and other symptoms disappear completely. If severe pain persists after three months, it is necessary to resort to a radical method - surgical treatment.

Prevention measures

There are no specific recommendations for preventing the disease. As a preventative measure, it is enough to follow simple rules that will prevent the development of neuroma:

From an early age, increased stress on the legs should be avoided: do not carry heavy objects, avoid prolonged standing, and often change position during the work process;
Buy shoes taking into account the anatomy of the foot. At the same time, the presence of a small heel cannot be ruled out - to preserve the arch of the bones;
Learn how to give a relaxing massage. It should be performed daily when pain occurs;
Bring your weight back to normal. Excess body weight significantly increases the load on the lower limbs;
Order orthopedic insoles taking into account the anatomical features of the foot. As mentioned above, such devices are designed to minimize the load on the metatarsal bones;
Timely contact with a specialist. An experienced doctor will see Morton's neuroma immediately on an x-ray and give recommendations on how to treat this pathology.

Undesirable consequences of Morton's disease

If a visit to a specialist is delayed or if the orthopedic surgeon’s orders are not followed, the pathological process can provoke the following negative manifestations:

Pain syndrome of significant intensity, which cannot be relieved even with the help of potent analgesics;
The appearance of lameness;
Inability to use stylish modern shoes;
Scoliosis;
Mental disorders and depressive conditions.

Recovery prognosis

The prognosis is quite favorable. If there is no result from the use of conservative methods, complications can be prevented by removing Morton's neuroma with a laser. This helps prevent further loss of foot function and complete loss of motor activity.

If the patient turns to a specialist at the initial manifestations of the disease, it will be possible to stop the inflammation through physiotherapeutic methods and medications. In the absence of timely treatment measures, this is fraught with serious complications. The affected area expands, and painful attacks become longer and more intense. In advanced stages of the disease, Morton's neuroma can only be treated through surgery, which is confirmed by reviews.