Metatarsalgia Morton is a pain syndrome in the toe area. It has different names: Morton's neuroma, interdigital neuroma, Morton's neuralgia. Neuroblastoma is a rather unfortunate term as it suggests a benign tumor of the nerve, which is rare in this syndrome. The term neuralgia reflects the nature of this disease much better. What are the causes, symptoms, and treatment of this neuralgia?

Morton's metatarsalgia(Morton's neuroma, interdigital neuroma, Morton's neuralgia) accounts for approximately 9 percent of foot pain. It is more common in women, especially between the ages of 40 and 50. It can occur on one side or in both feet.

Morton's metatarsalgia: reasons

Due to the overload of the foot, there may be enough pressure on the transverse ligament (it strengthens the transverse arch of the foot) on the common plantar nerve of the fingers or its overstretching and inflammation. As a result, degenerative changes occur in the metatarsal area.

Morton's metatarsalgia: risk factors

  • high raise
  • narrow forefoot
  • transverse flat feet
  • hollow foot
  • hammer and hammer toes and hallux valgus
  • obesity
  • inappropriate footwear (too narrow / pointed, high-heeled)
  • injury to this area of ​​the foot
  • diseases in the immediate vicinity of the plantar nerve, e.g. lipoma, ganglion, bursitis, inflammation of the capsules or metatarsophalangeal joints

Morton's metatarsalgia: symptoms

  • the first symptom is tingling in the area between the toes or the metatarsal, mainly on the plantar side
  • the symptoms worsen over time and pain ailments appear
  • the pain is acute - described by patients as gunshot, burning or burning
  • there may be a feeling of contraction of the fingers
  • ailments worsen when standing, running and wearing high-heeled shoes
  • patients start walking on the side edges of the foot to avoid pain
  • relief is provided by rest, taking off shoes and foot massage
  • symptoms may be presentchronically or sporadically - e.g. two / three times a week for no specific reason

Morton's metatarsalgia: diagnosis

You need an orthopedic or podiatrist consultation who will perform a thorough foot examination, including the Mulder test. The doctor grasps the metatarsus with a pincer grip and squeezes it, as a result of which the heads of the metatarsal bones lying next to each other move towards each other. This causes pain in patients with Morton's metatarsalgia.

If in doubt, an X-ray should be performed to exclude a fracture or sprain of the foot joints and to assess the correct alignment of the metatarsal bones. Ultrasound or magnetic resonance imaging is recommended for soft tissue examination. in the differential diagnosis, one must take into account inflammation of the synovial bursa or joint capsule, bone necrosis or fatigue fracture of the metatarsal bones.

Morton's metatarsalgia: treatment

The first step is to try non-surgical treatment. The basis is to obtain individually selected insoles for shoes. Well-made insoles are able to restore the correct load on the foot and relieve pain caused by Morton's neuralgia. In addition, diagnosed people should avoid narrow shoes that cause pressure on the forefoot and high heels that will increase the load on the metatarsal heads. If these methods do not bring the desired therapeutic effect, the next step is to perform the block, i.e. to inject a steroid drug under ultrasound guidance. In Morton's disease, rehabilitation is also recommended, consisting in obtaining full mobility of the forefoot by performing tissue massage and manual therapy and the use of functional fascial taping. Unfortunately, in 80% of cases, Morton's neuralgia must be treated surgically. The procedure involves surgical excision of the nerve or its decompression (removal of the tissues causing compression of the neuroma). This operation is relatively quick and minimally invasive (when performed from the dorsal side). Usually, it enjoys good long-term results, but sometimes the symptoms reappear after surgery. Rehabilitation is recommended, consisting in softening the postoperative scar and massage of the foot tissues.

Morton's metatarsalgia: prognosis

Usually, about 25% of patients avoid surgery, and their symptoms are controlled with an orthopedic insert or possibly with injections. 75% of patients after surgical treatment enjoy the absence of recurrence of disease symptoms. Others may require reprocessing in cases where decompression has not been adequately delivered or when it is accidentalfragments of nervous tissue were left.

Important

Metatarsalgia and Morton's neuromaMetatarsal osteochondrosis causing micro fractures called "walker's foot" may cause the same pain symptoms. If they are underestimated for a long time, fibrous connective tissue surrounds the irritated nerve, creating an overgrown nodule, which is then the actual Morton's neuroma.

Category:

Spine, bones, joints