Foot
Morton's Neuroma
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Morton's Neuroma
, Morton Neuroma, Interdigital Neuroma, Morton's Metatarsalgia
Definition
Perineural fibrosis of plantar nerve
Affects medial and lateral plantar branch communication
Mechanism
Repetitive
Trauma
Secondary Fibrosis
Painful fusiform swelling of nerve
Epidemiology
Women more often affected than Men
Symptoms
Severe burning pain at third web space
Numbness in affected toes
Radiation of pain into third and fourth toes
Provocative
Worse with activity
Aggravated by tight shoes
Palliative
Relieved by removing shoe
Relieved by massaging foot
Signs
Mulder Click Test
Dorsiflex the foot
Squeezing the
Metatarsal
s results in a "clicking" sound in Morton's Neuroma
Differential Diagnosis
Plantar Fasciitis
(if affecting tibial nerve in proximal foot)
Management
Conservative therapy
Often does not provide relief
Pad to separate third and fourth
Metatarsal
s heads
Avoid tight fitting shoes
Morton's Neuroma Injection
Management
Surgery
Corticosteroid Injection
Surgical Excision of Neuroma
Indicated in failed conservative management
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