Morton's metatarsalgia (Morton's neuroma)

Morton's metatarsalgia (Morton's neuroma) is a benign tumor caused by the proliferation of fibrous tissue around the branches of the plantar nerve. As a rule, Morton's neuroma develops between the middle and ring fingers of the foot, cases of tumor localization between the index and middle fingers are less common. As a rule, metatarsalgia affects only one foot: cases of its development on both legs are extremely rare.

 

The proliferation of fibrous tissue may be caused by compression of the nerve by the metatarsal bones. The cause of metatarsalgia may be transverse flat feet or prolonged significant overloads of the forefoot, uncomfortable narrow shoes with heels. The development of a neuroma can also be triggered by acute injuries, fractures of the metatarsal bones resulting from hematoma injuries.  Sometimes it is provoked by changes in the structure of the nerve and lipomas of various types.

 

The symptoms of Morton's metatarsalgia do not always include external changes in the foot, but the patient complains of irritation and pain, numbness, burning and tingling in the finger area; when palpated, the pain increases dramatically.

Pathology is diagnosed based on the patient's medical history and examination. If necessary, ultrasound and MRI are performed. A pathognomonic, i.e. unambiguously indicative of this disease, symptom of Morton's neuroma is a characteristic clicking sensation with simultaneous pressure on the interdigital spaces and an exponential increase in pain when the foot is squeezed from the sides.

 

Conservative treatment consists in wearing orthopedic comfortable shoes and using nonsteroidal anesthetics and antiseptics to relieve pain and inflammation. In some cases, steroid medications are prescribed.

Surgical treatment is indicated in cases where conservative treatment is not effective enough. In this case, surgical removal of the fibroma and excision of a part of the nerve is performed. The operation is minimally traumatic and minimally invasive, so the patient is shown to increase the load on the foot as the swelling decreases, starting the very next day after the operation.