When you have a neuroma, that means the nerve traveling between your foot’s metatarsal bones is enlarged. Typically, the nerve between your third and fourth toe is affected, and that’s when it’s called a Morton’s neuroma, a condition that causes numbness in your toes, or stabbing, burning pain in the ball of your foot.
Why do Morton’s Neuromas form?
When we say that your nerve is enlarged, we actually mean it’s swollen. And that swelling develops when your foot bones put pressure on the nerve. As the swelling sets in, the nerve also develops inflammation, leading to the pain of a Morton's neuroma.
Now, your foot bones put pressure on the nerve when they compress. And that compression could be the result of pointy-toed or narrow shoes. Additionally, wearing high heels can contribute to a neuroma, since these shoes put more pressure on your ball of foot. As such, women develop neuromas more often than men do.
Signs and Symptoms
How can you tell if you have a Morton’s neuroma?
Here are some of the most common symptoms:
• Pain when you wear narrow or high-heeled shoes
• Ball of foot pain that can be dull, sharp or even feel like numbness
• Pain or numbness in your toes
It’s best to come into the office at the first sign of symptoms, since an untreated neuroma will become progressively more painful.
Diagnosing Morton’s Neuroma in Powder Springs
When you come in to our Powder Springs podiatry practice, Dr. Alvin Cowans can diagnose Morton’s neuroma after a clinical examination and a medical history. After the physical exam, you may still need a diagnostic x-ray, just to rule out additional concerns such as stress fractures. In some cases, an MRI or ultrasound may also be necessary to fully understand the cause of your ball of foot pain.
Treating Morton’s Neuroma without Surgery
Depending on the severity of your condition, we may be able to relieve your discomfort with conservative treatment methods. Here are some of the best non-surgical treatments for this cause of pain in the ball of your foot.
One of the simplest solutions when your nerve is enlarged is to switch up your foot gear. We’ll guide you towards wider shoes that put less pressure on the bones in your feet, also reducing pressure on your nerve. Worn out kicks or super high heels will have to be avoided. And you’ll also need to steer clear of pointed shoes that can squeeze your toes. By giving your toes a break from external pressure, your nerve can get a much needed break. In turn, the inflammation can resolve, reducing your pain.
In some cases, a simple shoe change won’t be enough to take pressure off your feet. If, for example, your foot structure is causing pressure on your nerve, you’ll need a pair of custom orthotics to find relief. When you wear this medical grade shoe insert, it redistributes pressure in your feet that may be caused by your body’s mechanics. Already, this will take pressure off your nerve. But if you need a bit more support, we can also add a metatarsal pad to your orthotic. This will give your bones extra support, preventing compression and further reducing pressure on your nerve.
Medication to Reduce Inflammation
As we mentioned earlier, Morton’s neuroma pain is mostly the result of inflammation in your nerve. Therefore, taking anti-inflammatory medication reduce inflammation—and pain—at a faster pace.
Injections to Help Morton’s Neuroma
For a next level solution to nerve inflammation, many patients benefit from a cortisone injection instead of oral medications. You see, when we offer an injection, we can directly target inflammation where it’s causing problems—at the site of the inflamed nerve. Because of that direct delivery, just one cortisone injection can provide significant pain relief to neuroma sufferers. In contrast, when you take an oral anti-inflammatory, it has to travel through your whole body, providing slower and less effective relief for pain and inflammation.
Now, the effects of cortisone injections don’t last forever—in fact, they wear off after about two weeks. Still, because of the nature of neuromas, that two week period should be long enough to heal inflammation in your nerve. As a result, by the time the shot stops working, your pain should be resolved naturally. Of course, the pain and inflammation may still return. (Especially if you don’t follow our guidelines for proper foot wear. Or if you stop wearing your orthotics.) Still, many people report that their Morton’s neuroma is resolved with just one cortisone injection. But, if that’s not the case for you, surgical treatment could provide more permanent relief.
Treating a Morton’s Neuroma with Surgery
The majority of our patients find successful pain relief with conservative treatment. However, if you experience persistent ball of foot pain after trying less invasive options, it may be time to consider surgery. Luckily, treating Morton’s neuroma surgically is a fairly straightforward process. Basically, Dr. Cowans detects and removes the inflamed portion of your nerve (the neuroma.) Once it’s out of your foot, your pain is resolved.
Now, because we remove a piece of your nerve during this procedure, there may be mild numbness after the procedure. Still, most people prefer mild numbness to the stabbing pain of that relieved Morton’s Neuroma. After, you can bear weight on your foot right away—as long as you wear your surgical shoe. That will be a requirement for several weeks after surgery, while your incision heals. Then, once your boot comes off, you should be able to resume normal activities, free of the pain that plagued you before.
Who Should Treat a Morton’s Neuroma?
Because neuromas are such common foot problems, your foot specialist in the Lost Mountain neighborhood of Powder Springs is best suited to diagnose and effectively treat your Morton’s neuroma. When you schedule an appointment with Dr. Alvin Cowans, he’ll conduct a thorough exam and discuss all treatment options. Contact our office today to begin your recovery!