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MSK Podiatrist Steve Anderson answer your FAQs about Morton’s Neuroma

Steve Anderson, Musculo-Skeletal (MSK) Podiatrist
Claremont Clinics: Monday AM
 
What is Morton’s neuroma?
Morton’s neuroma is one of the most common foot problems there are. It’s thought that around 80% of people have at least one neuroma in their feet, they are just not always aware of it.
A neuroma is an inflamed and thickened nerve which in the foot most commonly occurs between the third and fourth toes but they can also be present between the second and third toes and less commonly between the fourth and fifth toes.
 
What are the symptoms?
When affected, people will often describe the sensation of having a pebble stuck in their sock or shoe although there isn’t anything actually in the shoe or sock. It can also cause tingling, pins & needles and/or numbness in the ball of the foot and affecting the toes. As symptoms worsen the pain can worsen to sharp stabbing or shooting pains radiating into the toes and are generally worse during weight bearing activities or when wearing tight shoes which squeeze the forefoot. Symptoms can last from a few minutes to being constant even when resting.
 
What causes Morton’s neuroma?
They are caused by low level repetitive trauma to the nerves between the toes and can occur at any age and in one or both feet. The exact cause of the trauma varies but can be linked to:
  • Wearing tight, pointed toe or high-heeled shoes.
  • High impact activities – running, dancing, zumba to working on hard concrete surfaces.
  • Other foot problems such as bunions, flat feet and claw toes.
 
What should I do if I think I have a neuroma?
One of the first things someone can do for themselves is look at their footwear. Shoes should be a comfortable fit with plenty of room for the foot (“wiggle room for your toes”) and good shock absorption. Shoe sizes are only a guide and feet do spread as we age so it is important to always make sure when buying shoes that they are a comfortable fit and not simply based on the size written on the label. If there are certain activities which cause the onset of pain, consider if it’s possible to alter how you do that activity.
If you are still struggling with pain then either seek further advice from your GP or make an appointment to see an MSK Podiatrist.
 
What will the podiatrist do?
First thing would be to examine the foot (or feet) to help determine  that it is in fact a neuroma that is causing the pain as there are other forefoot problems which can mimic the symptoms, e.g. bursitis or capsulitis (inflamed joint capsule). This is done through a combination of taking a history of the symptoms, physical examination and sometimes Ultrasound scans.
 
What about treatment?
As well as looking at footwear and footwear habits, conservative treatment can also involve orthotic insoles to offload the site and steroid injections. Pain medications can sometimes help reduce symptoms and if you are overweight, then controlled weight loss can also assist in reducing pain levels.
If the neuroma fails to respond to all treatment measures, then the last resort is surgery (which can also be provided here at Claremont under the care of the Sheffield Orthopaedic Ltd (SOL) Sheffield Foot & Ankle Centre). This is done as day surgery, usually under local anaesthetic with a small incision made on the top of the foot and the neuroma then carefully excised from the web space. The trade off with surgery is numbness in the web space instead of the sharp pains.
 
So should you be worried about having a Morton’s neuroma?
It is important to remember that these are actually a really common occurrence which although they can be very painful, are harmless and that the majority of people with them manage them very successfully with conservative treatment and continue to maintain an active lifestyle.
 
If it is causing pain or you are worried, Steve Anderson will be happy to see you at Claremont. A private consultation with Steve costs £120 for an initial consultation if you don't have health insurance.
For more information or to book an appointment call our Private Patient Team on 0114 263 2114.
If you wish to claim on your medical insurance you will need a referral letter from your GP or you can see one of our Private GPs quickly for this if you prefer. 
Date: 09/05/2017
By: Paula Lee
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