Pain causing Plantar Fasciitis & Morton’s Neuroma
Why does my foot hurt?
A painful foot can be debilitating and prevent people from participating in activities as simple as standing or walking. This can be caused by trauma, overuse, or conditions causing inflammation involving any of the bones, ligaments or tendons in foot. Arthritis is the most common cause of pain in the foot however inflammation in the nerves and fascia can be just as debilitating.
What are the common non-arthritis causes of foot pain?
What is a Morton’s Neuroma?
A Morton’s neuroma is a benign thickening of the tissue around a nerve leading to the toes. This usually occurs between the third and fourth toes and feels like a pebble in the shoe with an associated numbness and pain in the ball of the foot or toes.
Who gets a Morton’s Neuroma and what causes it?
Morton’s neuromas are more common in middle ages females and usually occur in one foot. The cause is usually due to excess pressure on the nerve due to the narrowing of the space between the toes resulting in thickening and scar tissue formation.
What are the symptoms of Morton’s Neuroma?
How do you a diagnose Morton’s Neuroma?
Dr. Chow will take a thorough medical history and physical examination to delineate the nature of the pain, evaluate the degree of functional impairment and consider any other possible causes of pain in the foot.
Morton’s neuroma is often a clinical diagnosis however imaging is often required to rule out other causes of pain and confirm the neuroma. Xray, MRI and Ultrasound may be ordered by Dr. Chow depending on clinical examination.
What is the likely course for a Morton’s Neuroma if not surgically managed?
20% of patients will have a resolution of symptoms with non-operative management. It is difficult to recognize the patients that will be successful with non-operative measures and all attempts at conservative treatment should be initially trialed.
What are the non-operative treatments for a Morton’s Neuroma?
Non-operative treatments should be trialed for at least 3 months prior to considering operative intervention.
Non operative measures include:
When do I require surgery for a Morton’s Neuroma and what does it involve?
Surgery is considered after 3 months of failed non-operative treatments. Surgery involves cutting out the compressed nerve and surrounding scar tissue. This has an 80-90% success rate but result in PERMANENT NUMBNESS in the affected toes.
What to expect after Morton’s Neuroma surgery?
Morton’s Neuroma surgery is generally done as a day surgery procedure. You will go home in a post-operative shoe with pain relief and advised to elevate the leg are 1-2 days.
Dressings are to remain dry and intact until your first post-operative appointment. Your sutures will be removed after 2 weeks and scar massage and desensitization commenced. You should be able to return to a normal shoe at 2 weeks and full activities at 6 weeks.
Potential complications of Morton’s Neuroma surgery
All surgical procedures involve inherent risk of complications. However, these risks are generally uncommon and quite infrequent. These include anesthetic complications, wound infections, recurrence of the neuroma, injury to blood vessels supply the toe, chronic regional pain syndrome and blood clots
Patients can minimize the risk of complications by carefully following post-operative instructions.