Mortons Neuroma, where exactly do you get them in your feet and what do they feel like?
Hi, I’m Ben from the Foot and Ankle Clinic in Darlington, and today I’m going be looking at Morton’s neuroma, and we’re using my foot model, Lucy. And we’re drawing on the foot to show you where you might be getting the tingling and sort of burning sensations that go into the toes and where they’re going to be coming from. So, first of all, you have four nerves that sit between your metatarsals, and they will start around about here and they terminate there, and another one here and there, and then there and down here, okay. And they go from there top through to the bottom. You’ve also got a fifth one down here on the outside. That one’s very, very rare that you get any issues with that. That’s more with bunions that we see that particular problem. But as a general trend, we tend to see issues and burning sensations in these four areas here.
So it can be between the first and second, the second and third, third and fourth, and the fourth and fifth. It can be between a number of them as well. It’s a slight thickening of the nerve and some structures are trapping that particular nerve as it’s passing through from the top of the foot through to the bottom. Once it gets irritated, it thickens, and that’s just called a neuroma.
The most common things that we hear from patients are that it is a burning sensation, a sort of numbness and tingling actually into the toes. Essentially, when people bend down to pick things up, that’s where you see the toes getting round and people say it hums a lot then, or it feels like you’re walking on a hot stone.
Speaker 1:
Today, we’re going to be talking about why with MORTONS NEUROMA surgery should be a last resort.
Speaker 2:
So we’re talking about steroid injections that are used for MORTONS NEUROMAs and also the surgical option of basically having the tissue removed. The steroid injections, they can work for some people, but they tend to be temporary success rates and you’re likely to get a recurrence with them. So it’s invasive, you’ve got a risk of infection and for not a very good outcome. So although they really do work for some people, they really should be a last resort. And then what about surgery?
Speaker 1:
With surgery,, it can be very good. Some people have it done and it’s absolutely fine, but for a lot of people, they have it done and they can have recurrent problems afterwards. There can be infections, there can be sort of phantom pains from where the actual nerve used to be, and there can just be nerve damage in there as well, further up.
Speaker 2:
Another problem that we’ve had with a couple of patients that we see a scarring in the area as well, and actually callousing problems over scars can be just as painful as when they actually had the condition in the first place. So any invasive procedures on feet should be a last resort because they’re very delicate, there’s lots of structures in a small area. And so basically a lot can go wrong.
Speaker 1:
And it’s always best to have the non-invasive longer-term solutions rather than solutions that can be short term on that front.
Speaker 2:
Absolutely. So some options, just so that you’re aware of them, manipulation, mobilization, something called fascia manipulation as well, and insoles.
Speaker 1:
Yup, certa
in types of insoles can be very useful.
Speaker 2:
And most people will respond to one or the other combinations of everything together. So lots of noninvasive options, no need to go straight in with steroid injections and surgery.
Speaker 1:
I’m Ben from Foot and Ankle Clinic in Darlington.
Speaker 2:
And I’m Lucy.