A neuroma is inflammation of a nerve. In the foot the most common location is in between the 3rd and 4th Metatarsal heads. The reason this location is so common is because the branch from the Lateral plantar nerve combines with a branch from the Medial plantar nerve to innervate the space between the 3rd and 4th toes. Therefore, the area where the two nerves meet is anatomically thicker – making it more prone to irritation. Each patient suffering from a Mortons Neuroma may have differing sensations. A Neuroma may burn, tingle, feel numb, or feel extremely painful (often described as a sharp shooting pain).
More conservative treatment involves proper footwear. Shoes with a pointed toe will cause compression of the metatarsal heads, thus irritating the plantar nerves. This pain can be replicated by a test known as a Mulders Click. Custom molded foot orthotics may be prescribed. Orthotics would be prescribed to address the faulty biomechanics. Marked forefoot splaying may be due to a pes planus or hypermobile foot. Addressing this will prevent the metatarsal heads from being compressed in foot wear. The Chiropodist may also prescribe medication, such as NSAIDs (topical and/or oral) to help with the painful sensation. More invasive procedures will include corticosteroid injections, and surgical excision.
Patients who suffer from a Mortons neuroma will often not forego seeking treatment due to the severity of altered sensation/pain. The pain will not go away unless the cause is addressed.