As you walk, a strong the foot (the metatarsal ligament) pushes downwards, while the ground effectively pushes back up. The digital nerve is compressed between the two, and if it is even slightly enlarged, it will cause pain.
The enlargement or swelling of the nerve
can be caused by irritation to the nerve, which might
be the result of flat feet, wearing too tight shoes
or high heels, or a result of an injury or trauma to
the foot.
Persistent burning pain the ball of the foot – feeling as though you are ‘walking on a marble’. The pain may radiate into the toes, occasionally causing numbness in the toes. It mostly occurs between the third and fourth toes. It’s generally felt when you’re moving about, especially when wearing high-heeled or tight shoes.
There will be a distinct pain between the bones of the affected toes, which sometimes ‘click’ when manipulated.
A thorough examination of the foot will determine if the pain is caused by something other than Mortons Neuroma, such as in the bones, or by calluses or . An MRI scan will ascertain that there is no tumour in the foot. Tests on the way your foot moves can rule out arthritis or joint inflammations as the cause of pain.
It is possible to treat Mortons Neuroma with simple, non-surgical procedures such as the following:
- Wearing wider shoes with lower heels, which allows the toes to spread out and reduces pressure on the digital nerve, enabling it to heal.
- Orthotics – tailor-made inserts for your shoes which lift and separate the bones, and reduce pressure on the nerve.
- Injecting corticosteroid can reduce the inflammation and bring relief from pain.
If Mortons Neuroma does not respond to the above procedures, minor surgery is usually recommended.
The Dorsal Approach
An incision is
made in the top of the foot, which means that the patient
will be able to walk soon after surgery – because
the stitches are not on the underside of the foot.
The surgical instruments have to be carefully manoeuvred through all of the complex structures of the foot, and the surgeon will cut deep into the metatarsal ligament, which will reduce the compression of the nerve.