Morton's Neuroma: Causes, Symptoms, Treatment and Cost

Morton's neuroma is a painful ailment that impacts the ball of the foot, usually between the third and fourth toes.

• Interdigital Neuroma: This is the most common type of Morton’s neuroma and occurs when a nerve in the foot becomes compressed between two metatarsal bones in the toes, causing pain, numbness, and tingling.
• Plantar Neuroma: This type of Morton’s neuroma occurs when the nerve becomes entrapped in scar tissue on the bottom of the foot, usually caused by an injury or a deformity such as bunions or hammertoes.
• Perineural Neuroma: This type of Morton’s neuroma occurs when a nerve is compressed by adjacent muscles or ligaments in the foot, causing pain and numbness in the affected area.
• Intraneural Neuroma: This type of Morton’s neuroma occurs when a nerve becomes entrapped within its own sheath or an adjacent structure, such as a muscle or ligament, resulting in pain, numbness, and tingling.

• It is thought to be caused by prolonged use of narrow-toed shoes, high heels, or other shoes that compress the toes together.
• Repetitive activities such as running or sports can also cause pressure on this area, leading to Morton's Neuroma.
• Disorders such as bunions and a floppy toe can place additional pressure on the nerve, leading to a neuroma.

• Burning, stinging or throbbing pain in the bottom of the feet between the third and fourth toes.
• Pain that increases when an individual stands or walks on their toes.
• Tingling or numbness in the toes on either side of the affected area, sometimes extending to other toes or down towards the heel of the foot.
• Foot cramps/muscle spasms during physical activities like running or jumping.
• Difficulty comfortably fitting into shoes due to increased pressure in a particular spot on the foot near where Morton's neuroma develops.

• Wear shoes with wide toe boxes and good arch support.
• Select footwear with adequate cushioning to absorb shock.
• Exercise to strengthen foot muscles and increase flexibility.
• Avoid activities that require you to use your toes often, such as jogging and high-impact aerobics.
• Use orthotic inserts to reduce pressure and help redistribute weight.

• Physical examination: The doctor will examine your feet to compare their size and shape and check for any swelling or tenderness around a nerve close to your toes. The doctor may also press on various parts of your feet to identify any areas of discomfort due to Morton's neuroma.
• Imaging Tests: Imaging tests such as an X-ray, MRI scan or ultrasound scan can be used to assess the condition of your feet and surrounding muscles and ligaments so that any abnormalities can be identified more easily, including any bone spurs or compression on a nerve near your toes that might be causing Morton's neuroma.
• Neurological Tests: Nerve conduction studies can help diagnose Morton's neuroma by measuring how quickly electrical signals are moving through the affected nerve near your toes, helping to confirm if it is being compressed or irritated due to Morton's Neuroma.
• An injection test: A local anaesthetic injection around the affected area may help diagnose pain due to Morton’s neuroma by providing temporary relief from symptoms; if no relief occurs after an injection then it suggests that something else is causing pain in that area other than Morton’s Neuroma

• Pain/Burning, Tingling/Numbness: These can be felt in the areas of your toes and feet affected by Morton’s Neuroma.
• Swelling of the metatarsal: Swelling in the area of your metatarsal, located between the toes, is common and can cause considerable discomfort.
• Difficulty Walking: As pressure increases on the nerve from an irritated metatarsal, it may become difficult to walk normally or even put any weight on foot at all.
• Balance Problems: An inflamed neuroma can lead to balance problems as your body struggles to adjust to abnormal movement and pressure in your foot as a result of swelling and nerve irritation.
• Joint pain: The inflammation caused by Morton's Neuroma may cause joint pain elsewhere in your body, including hips, knees and ankles depending on how you redistribute weight while walking or standing due to Morton’s Neuroma pain relief plan needed.

• Massage with ayurvedic oils such as vacha oil and sesame oil can be helpful in reducing the symptoms of Morton's neuroma.
• Panchakarma, Abhyanga, Swedana, and Basti are Ayurveda treatments that may help decrease inflammation and enhance general health.
• Herbal supplements such as Bala, Guduchi and Yashtimadhu can be taken on a regular basis to reduce pain and inflammation associated with Morton's neuroma.
• Practising yoga postures such as Paschimottanasana, Vrikshasana, Bhujangasana and Janu Sirsasana can be beneficial in reducing pain and inflammation associated with Morton's neuroma.

• Lean proteins like grilled chicken, fish.
• Complex carbs like quinoa, brown rice, sweet potatoes, or oats.
• Vegetables such as broccoli, Brussels sprouts, kale, spinach or other leafy greens.
• Apples, oranges, and other varieties of fresh fruit.
• Healthful fats found in avocados, nuts, and seeds.
• Low-fat dairy products such as yoghurt or cottage cheese.
• Drink a lot of water to keep yourself hydrated.

• Foods high in sugar, such as soda and candy, can worsen inflammation related to Morton’s neuroma and should be avoided.
• Spicy foods can cause increased inflammation, so it might be helpful to avoid these as well.
• Coffee, energy drinks, and other caffeinated drinks might increase the symptoms of Morton's neuroma by dehydrating the body.
• Alcoholic beverages should be limited or avoided if you have Morton’s neuroma due to their dehydrating effects and potential to increase inflammation.
• Foods that are processed or high in saturated fats may trigger inflammation or discomfort related to Morton’s neuroma and should be limited as much possible

• Rest: Taking a break from activities that cause pain can give the feet some much-needed relief and allow the inflammation to subside.
• Ice: Pain may be alleviated by using an ice pack to minimise swelling in the affected region.
• Shoes: Pain alleviation may be achieved by wearing shoes with a wide toe box and low heels.
• Orthotics: Inserting orthotics into shoes can help improve foot alignment and provide more support to reduce pressure on the affected area.
• Surgery: Some patients with Morton's neuroma may need surgical intervention to remove tissue around the damaged nerve or to relieve pressure on the nerve.

The type of doctor that should be seen for Morton's Neuroma is either an orthopaedic surgeon or a podiatrist.

An orthopaedic surgeon specialises in injuries and diseases of the musculoskeletal system, while a podiatrist specialises in feet, ankles and lower leg issues.

• Non-steroidal anti-inflammatory drugs (NSAIDs): Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen may help decrease inflammation and discomfort from Morton's Neuroma.
• Oral Steroids: Oral steroids such as prednisone can help reduce inflammation and pain caused by Morton's Neuroma.
• Topical Agents: Anaesthetic or corticosteroid creams, gels, or ointments may also be prescribed to reduce pain and inflammation.
• Antidepressants: Tricyclic antidepressants (TCAs) can help manage the pain associated with Morton's Neuroma; they may also increase blood flow to alleviate the pressure on the neuroma nerve endings.
• Androgel (testosterone gel): This medication has been found to relieve symptoms as a result of its anti-inflammatory properties as well as increased vascularity around the nerve fibres of the neuroma that reduces pressure on them; caution is advised for female patients due to potential masculinizing effects of testosterone supplementation.

Generally, if surgery is required, recovery usually takes about 6-8 weeks for swelling to subside and for full strength to return.

If only conservative measures (such as rest, switching shoes, custom orthotics) are used, it can take several months to reduce symptoms and lessen pain in the foot.

For some cases, complete resolution may not be achievable but symptoms can be managed with continued conservative treatments.

Morton's neuroma treatments often have long-lasting effects. Most people experience a complete resolution of their symptoms with proper treatment and care, including injections or surgery.

• The post-treatment guidelines for Morton's Neuroma vary depending on the type of treatment chosen.
• Generally, patients should rest and avoid activities that aggravate the condition, such as walking or running in tight shoes.
• Applying ice to an area might help lessen swelling and discomfort.
• Wearing comfortable, wide shoes with plenty of room for the toes can help prevent further irritation of the nerve.
• Physical therapy and steroid injections may be suggested in certain circumstances.

Treatments for Morton's neuroma in India typically range from ₹10,000 to ₹50,000 depending on the severity of the condition and the type of treatment chosen.

Common side effects of Morton's Neuroma treatments may include swelling, bruising, and pain at the site of treatment.

There is also a risk of infection, numbness, nerve damage, and difficulty walking.

Other rare side effects can include changes in skin pigmentation and scarring.

You should see a doctor if you're having problems related to Morton's neuroma, since this condition may lead to serious side effects including 'abnormal walking, arthritis, back pain, etc.' and the duration of necessary treatment might vary from a few months to years.