Advanced Foot And Ankle Center Of San Diego

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Neuromas of the foot (Morton's Neuroma)

Please visit It’s Not a neuroma after reading this page

Morton’s neuroma is a benign neuroma of an intermetatarsal plantar nerve, most commonly between the third and fourth intermetatarsal spaces, stemming from the medial plantar nerve of the foot. Many will feel numbness and tingling between the third and fourth toes as well as a sock bunched up type of feeling under the foot. Or the feeling as if there is a pebble in ones shoe.

A neuroma is a soft tissue abnormality and won’t be visualized on standard radiographs.Even so the first step in the assessment of neuroma pain is an X-ray in order to evaluate for the presence of arthritis, exclude stress fractures/reactions and focal bone lesions, which may mimic the symptoms of a neuroma. An MRI can accurately demonstrates thickening of the interdigital nerve within the webspace of greater than 3mm, diagnostic of a Morton’s neuroma. This typically occurs at the level of the intermetatarsal ligament. Other conditions that may also be visualized with MRI and can be clinically confused with a neuroma include synovitis/capsulitis from the adjacent metatarsophalangeal joint, stress fractures/reaction and plantar plate disruption.

Direct pressure between the metatarsal heads will replicate the symptoms, as will compression of the forefoot between the finger and thumb so as to compress the transverse arch of the foot. This is referred to as Mulder’s Sign.

Orthotics and corticosteroid injections are widely used to treat Morton’s neuroma. Another method is Custom molded orthotics. If such interventions fail, patients have surgery known as neurectomy which involves removing the affected piece of nerve tissue.

Prior to any surgery my advice is , make sure its a neuroma. Have you had an MRI or Ultrasound to confirm it. Is it a Plantar Plate/ Casule tear or stress fracture????