Neuromas

Morton's neuroma is an enlarged nerve that usually occurs in the third interspace, which is between the third and fourth toes (see image above).

Signs and Symptoms
1. Pain between the 3rd and 4th toes most commonly, but can occur between other toes as well.
2. Most often in Women than Men and ages 18-60.
3. Sensation of walking on a wrinkle in a stocking or lumb in the shoe.
4. Toes may spread apart due to swollen nerve.
5. Sharp, dull, or throbbing pain and may feel electrical or some numbness.

Diagnostic test to confirm Neuromas
Diagnostic ultrasound
MRI

Treatment
1. Conservative treatment included metatarsal pads and wider shoes and orthotics.
2. Steriod injections.
3. Alcohol sclerosing injections.
4. Surgical removal of neuroma: plantar or dorsal approach. Plantar approach has better results and easier for surgeon to perform, but requires 2-3 week of non weight bearing.

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