Here’s a terrible riddle:
When is a tumor not a tumor?
Answer: When it’s Morton’s Neuroma.
Morton’s neuroma is a benign tumor of a nerve– and not technically a tumor, but rather a thickening of the tissue that surrounds the digital never leading to the toes. The technical term is a perineural fibroma. Think of it like feeling you’re walking on a rock while having persistent pain in the ball of your foot – that could be Morton’s Neuroma.
More Symptoms and signs
Pain on weight bearing – even after a brief time – could be a symptom. The nature of this pain can vary greatly between people – some experience shooting pains affecting the contiguous halves of two toes, while others describe a feeling like ‘walking on razor blades.’ Burning, numbness, and paresthesia may also be experienced. This symptoms progress over time, often beginning as a tingling sensation in the ball of the foot.
Treatment and diagnosis
Because there are no obvious deformities, diagnosis can be challenging. Often an MRI (magnetic resonance imaging) scan will be conducted to help in the diagnosis.
Once confirmed/suspected, conservative treatments for Morton’s Neuroma include orthotics and corticosteroid injections. In addition to traditional arch supports, a small foam or fabric pad may be placed under the space between the two affected metatarsals (toes), immediately behind the bone ends. This helps to create more space for the nerve, and relieve pressure and irritation.
Several studies have shown that through a combination of using roomier, more comfortable shoes (specially selected), anti-inflammatory medication and cortisone injections, 80% of people with Morton’s Neuroma can find effective relief. However, for some patients, if the above treatments are not enough to alleviate the pain, sclerosing alcohol injections are an increasingly available treatment alternative. Diluted alcohol (4%) is injected directly into the area of the neuroma, which is toxic to the fibrous nerve tissue. In clinical studies, this approach has a 60-80% success rate, far exceeding the surgical success rate[i]. Radio Frequency Ablation (link) is also used as an alternative treatment as well. Outcomes appear to be about on par with alcohol injections, especially if the procedure is performed under proper ultrasound guidance.
Experiencing Pain caused by Morton’s Neuroma?
Contact Coastal Orthopedics today if you are experiencing any pain caused by Morton’s Neuroma. We have four offices for your convivence, located in the Florida area. Call today at 941-792-1404.