Morton's neuroma is a fairly common disease, which is accompanied by the appearance of a benign thickening in the plantar nerve of the foot. Many terms are used to refer to the disease in modern medicine, including "Morton's toe syndrome", "perineural fibrosis" and "foot neuroma".
The growth of fibrous tissue in this part of the foot is accompanied by nerve compression. This disease can develop for years without causing much concern. But, despite the sluggish course, patients need qualified help. So what is Morton's neuroma (of the foot)? How dangerous can the disease be? What are the symptoms to look out for? Does modern medicine offer effective treatments? The answers to these questions are of interest to many people.
What is Morton's disease?
Morton's neuroma is a benign thickening formed by the growth of fibrous tissue. The neuroma is located in the area between the third andfourth toe. According to statistics, women are more likely to suffer from the disease. Doctors attribute this trend to the constant wearing of narrow shoes with uncomfortable heels. On the other hand, the disease also occurs in the male population.
At the initial stages, a neoplasm rarely causes serious inconvenience to a person. But as Morton's neuroma grows, it begins to compress the digital nerves, which affects the patient's well-being and the functionality of the foot. In most cases, the lesion is unilateral - only in rare cases, a neuroma affects both limbs at once.
Main causes of disease development
Why does Morton's neuroma develop? Unfortunately, to date, the exact causes of the onset of the disease are unknown. We can only say that the disease develops if the nerve fibers are constantly compressed by bones and ligaments. Scientists managed to identify several risk factors that, in a certain situation, can provoke the appearance of seals in the area between the phalanges of the fingers. Their list includes:
- The presence of overweight is considered one of the most common causes of the development of the disease, because the feet have to withstand heavy loads, which affects the work of the articular and bone apparatus.
- The reasons include the constant wearing of narrow, uncomfortable shoes, especially when it comes to high-heeled shoes. This leads to deformation of the foot, compression of the connective tissue elements and nerve endings.
- Sometimes a neuroma develops against the background of excessive physical activity, constant standing on your feet without rest.
- Flat feet are also a risk factor, because the nerve is compressed due to progressive deformation of the bones of the limbs.
- Risk factors also include injuries and bruises of the foot, infectious diseases that are chronic.
This is what the liver of causes that can lead to the development of such a pathology as Morton's neuroma looks like. Diagnosis necessarily includes procedures to find out what exactly provoked the formation of a neoplasm.
What symptoms accompany the disease?
As already mentioned, Morton's neuroma (feet) is characterized by sluggish development. At the initial stages, some characteristic symptoms may not be present at all. People note only a slight soreness and burning sensation when squeezing their toes. As the disease progresses, discomfort appears when walking. In the initial stages, patients feel soreness only while wearing tight shoes or high heels. Later, pain becomes a constant companion of a person.
Compression of the nerve may be accompanied by tingling and burning in the toes. Sometimes patients complain of foot numbness. The sensitivity of the skin in the area between the third and fourth toes decreases. There are no visible changes in the shape and structure of the limb, because neurinoma is not a tumor. Symptoms appear periodically and may disappear for many years. That is why many people take a long time to apply.
In the later stages of development, the patient's condition worsens dramatically. Soreness appears not only while standing or walking. Even at rest, a sharp, shooting pain in the foot periodically appears.
Morton's neuroma (feet): diagnosis
As a rule, already during a general examination, the doctor may suspect the presence of a neuroma. The clinical picture is characteristic. On palpation, patients complain of pain. A sick person is also offered to fill out a special questionnaire - so the specialist can collect the most complete information about the patient's he alth status, the presence of bad habits, the intensity of symptoms, etc.
X-rays are taken to confirm the diagnosis. In the picture you can see the presence of a thickening in the interphalangeal space. Informative is the ultrasound examination of the alleged area of the neuroma. Magnetic resonance imaging is performed only if the diagnosis is in doubt. The same study is necessary for patients who are indicated for surgery.
Drug therapy
What should patients do with Morton's neuroma? Treatment depends on the stage of development of the disease and the severity of the symptoms. Drug therapy is used to relieve pain and relieve inflammation.
Pretty effective are drugs such as Codelac, Nimesulide, Diclofenac, Solpadein, Ibuprofen. Medicationsused in the form of tablets and ointments. In the most severe cases, anesthetics are injected directly into the tissues of the affected area.
Other non-surgical treatments
The action of medicines is aimed only at relieving pain and inflammation. But patients need to follow some rules. First of all, you should stop wearing tight shoes. It is recommended to wear flat shoes with a wide toe and special orthopedic insoles. In order to prevent fingers from being compressed and deformed when walking, patients are recommended to use special separators.
It is also worth reducing the load on the feet, abandon physical activity, which involves prolonged standing, walking or running. Periodic courses of foot massage are recommended. Physiotherapeutic methods are also used to relieve inflammation and slow down deformation, including shock wave therapy, acupuncture, electrophoresis with the use of appropriate drugs, and magnetotherapy.
Pros and cons of conservative treatment
To begin with, it is worth noting that conservative therapy is effective only if the disease is diagnosed in the initial stages. This treatment has its pros and cons. Medicines and physiotherapy help to avoid surgery and its associated risks, including tissue scarring, infection, etc. In addition, there is no need for rehabilitation - during the period of treatment, a person is not obliged to break the usual rhythm of life.
Regardingcons, you need to understand that conservative treatment lasts for months, and sometimes years, and success can not always be achieved. Medicines used by doctors are not so cheap, and their long-term use is fraught with the development of side effects.
Morton's neuroma (feet): surgical treatment
The simplest method of surgical treatment is the excision of the neuroma, which, in fact, is part of the nerve. The procedure is performed under local anesthesia. In the projection of the heads between the third and fourth metatarsal bones, a small incision is made (about 2 cm long). The doctor immobilizes and removes excess tissue, after which the wound is sutured in layers.
This is how Morton's neuroma is removed. The operation is associated with excision of part of the nerve, therefore, after the procedure, patients partially lose sensitivity in the area between the metatarsal bones. However, the functionality of the foot is not affected.
There is also a less radical procedure - dissection of the ligament between the metatarsal bones. This procedure eliminates the compression of the nerve, allowing you to save the sensitivity of the fingers. In the event that the operation did not lead to the desired result, the neuroma is removed.
Osteotomy of the fourth metatarsal is much less common. During the procedure, which is carried out with the help of special equipment through small punctures in the skin, the doctor displaces the head of the metatarsal bone through an artificial fracture.
Advantages and disadvantages of operationalinterventions
Surgical excision of a neuroma has its own advantages. In particular, it is possible to get rid of the disease quickly. The therapy is successful, relapses are recorded very rarely. The cost of the operation is also not too high.
On the other hand, the success of treatment largely depends on the skills of the surgeon, so you should carefully consider the choice of a doctor. This is an open operation, so there is always a risk of tissue infection. Patients are prescribed a prophylactic course of antibiotics. Surgical intervention is associated with a long period of rehabilitation. However, in the most severe cases, this is the only possible treatment.
Rehabilitation after surgery
Like any surgical intervention, the removal of Morton's neuroma requires rehabilitation. The patient can go home a few days after the procedure. However, during the first few weeks, a constant change of dressings is necessary. Stitches are usually removed 10-12 days after surgery.
Depending on the complexity of the procedure, full recovery of mobility takes from 3 weeks to 2 months. Many patients complain of discomfort that appears while walking after surgery. This is normal and can be managed by wearing proper shoes, regular massages and therapeutic exercises.
Folk treatments for disease
Is it possible to get rid of a disease such as Morton's neuroma (feet) at home? Treatment with folk remedies is possible. For example, somefolk healers recommend using wormwood juice. To prepare the medicine, you need to pluck the fresh herb of bitter wormwood, grind and grind it to a pulp, then apply it to the affected area, securing it with a bandage.
Cope with pain will help and cream of pork fat. To do this, mix 100 g of fat thoroughly with ordinary table s alt (one tablespoon). The resulting ointment should be rubbed into the skin of the foot, putting a bandage on top.
It is worth noting that such remedies are not able to eliminate the disease. Ointments can only relieve soreness and other symptoms that Morton's neuroma leads to. Treatment with folk remedies is possible only after a preliminary consultation with a doctor. Sometimes homemade formulations are a good addition to drug therapy.
Prognosis for patients
It should be understood that the prognosis for people with a similar diagnosis directly depends on when exactly they received medical care. At the initial stages, the inflammatory process and irritation of nerve endings can be completely eliminated with the help of medicines and medical procedures.
The lack of therapy is fraught with dangerous consequences. The affected area only increases, and the pain is constantly increasing, significantly reducing the quality of human life. In the later stages, the only remedy for the disease is a surgical procedure.
Prevention measures
Unfortunately, completely secure yourself fromthe development of such a disease is impossible. However, following some recommendations, you can minimize the likelihood of developing a neuroma.
It is recommended to give preference to comfortable shoes, preferably with orthopedic soles. If there is a need to wear high-heeled shoes, then you need to regularly do warm, relaxing foot baths. Do not forget about the foot massage, which you can do yourself.
It is important to watch your weight too. Extra pounds negatively affect the state of the body and are associated with a lot of risks for the development of various ailments, including the gradual deformation of the bones of the foot. In the presence of flat feet, it is also necessary to undergo appropriate therapy.
If you belong to a risk group, then periodically you need to undergo medical examinations. Neurinoma, like any other disease, is much easier to treat with early diagnosis and timely medical care.
