Other common names
Who does it affect?
Often tends to affect females, most usually in
between the third and fourth toes.
Why does it occur?
The exact cause is unknown. A number of causative
factors have been suggested. Symptoms are exacerbated when a lot of
pressure has been placed on the forefoot, for example, during running or
standing for long periods. Certain footwear can also cause significant
pressures to be placed on the forefoot. Other conditions which can
intensify the mortons neuroma include the inflammatory or degenerative
conditions such as arthritis.
Investigations
Both ultrasound and MRI have been described for
imaging and neuroma.
X-rays of the forefoot may be required to exclude
any other forefoot pathology such as inflammatory or degenerative
arthritic conditions.
Non-operative treatment
Conservative treatment starts with alteration of
footwear. Shoe inserts can release the pressure on the entrapped nerve.
Anti-inflammatory medication or corticosteroid injections can help in up
to 70% of cases.
Operative treatment
Surgery is performed under general anaesthetic or
regional anaesthesia (only the leg is made numb). A tourniquet is used,
which is like a blood pressure cuff around the upper thigh to prevent
blood from obscuring the surgeon’s view and the swollen nerve is
excised. No plaster is required and patients are allowed to fully weight
bear post operatively.
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