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INJURY TITLE
| Mortons neuroma |
GENERAL INFORMATION
| A Morton’s neuroma is a condition that usually results in pain arising from the compression of the nerve that ends between the bones in the front of your foot near your toes. Often it is seen in-between the 3rd and 4th toes along from your big toe. This condition is more common in women than men and it is possible to affect both feet at the same time.
The foot comprises of many small bones, 5 of which are the long bones known as the metatarsals which are situated beside each other. Between these bones are nerves which supply the toes. During certain activities, particularly heavy weight-bearing activities (e.g. walking or running) a compressive force, is sometimes placed on the nerves and surrounding soft tissue (this is often the case with tight fitting shoes or flat feet). If this force is repetitive enough and beyond what the nerve and soft tissue can withstand, they can become irritated. As a consequence, swelling to the nerve and soft tissue may occur. This may result in pain, tenderness, pins and needles or numbness in the forefoot or toes. When this happens, the condition is known as a Morton’s neuroma. |
COMMON SIGNS & SYMPTOMS
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ASSESSMENT INFORMATION
| Clinical questioning with reference to the nature of the pain and onset of the condition. Questioning can highlight the presence of pins and needles or numbness along with the behaviour of the symptoms in response to your activities.
Clinical testing will involve palpation (touching) of the immediately tender area. Using compression of the ends of the bones in your foot to replicate your pain. Sometimes this may cause a clicking sound (if there is sufficient thickening of the connective tissue). Clinical testing should also focus on the function of the nerve tissue, and the mobility of the joints throughout your whole foot.
Pain in the front of the foot (in the area described) is often categorised as a neuroma but there are many other causes of pain around that area. It is important the clinical examination is specific enough to exclude these causes first. |
GENERAL TREATMENT
| Relative rest (especially if normal activities are aggravating the condition).
Ice and anti inflammatory medication can help with any swelling. Acupuncture can help with swelling and pain Corticosteroid injection may be required if the pain is sufficient enough. Biomechanical intervention (use of orthotics and foot pads to offload the painful structures). Wearing broader footwear will take pressure of the toes and thus off the nerves in between them, reducing pain. Rarely, a surgical intervention could be required, but this is only in extreme and persistent cases that don’t respond to normal conservative treatments. |
WHICH HEALTH PROFESSIONAL TO CONSULT
| PHYSIO X | MEDIC X | PODIATRY X |