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Neuromas

neuromasNeuromas

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. Steroid injections.

3. Dehydrated Alcohol sclerosing injections.  These injections are done every 7-10 days for up to 8 injections.  They are usually done until the symptoms have dissipated.  These injections are usually done prior to surgery.  If they are not successful, then you should wait about 2-3 months before  surgery is attempted to remove the neuroma.  Podiatry today writes about if injections can help reducing pain from a neuroma.

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.