What is a Morton’s neuroma?
A neuroma is a term used to describe an enlarged nerve. The problem is often referred to as metatarsalgia. Morton’s neuroma is the most common nerve entrapment in the foot leading to numbness and shooting pain under the ball of the foot and between the toes. Neuromas are most commonly found between and 3rd – 4th toes but can present between any two toes. We often find patients with neuromas also have 2nd and 3rd toes that are very close to each other or have recently started to separate. Bunions/enlarged big toe joint, flat feet, high arch feet, clawing of toes and hard skin under the ball of the foot are also common findings.
Do I have a neuroma?
Most of our patients describe burning or numbness pain under the ball of the foot and into the toes. They also describe feelings of a ‘pebble’ under their foot when in shoes or walking barefoot.
Unfortunately neuromas are often not diagnosed accurately. The diagnosis of a Morton’s neuroma requires experience in the clinical assessment and history taking of patients. In some cases an ultrasound or MRI diagnostic imaging may be necessary to determine the exact location and size of the neuroma. Dr Azarian is highly skilled and experienced in the diagnosis and management of neuromas.
What causes a neuroma?
Many factors can contribute to the development of Morton’s neuroma. Some include:
- Entrapment due to pressure from bones on either side of the nerve
- Poor foot alignment and function
- Bunion deformity
- Arthritis of the big toe joint
- Long metatarsal bones
- Flat feet
- High arch feet
- Certain conditions
- Excessive wearing of high heel shoes
- Tight/pointy footwear
Neuroma treatment in Perth
Dr Azarian advises on non-surgical treatment for most patients. The success of these treatments depend on the size of the neuroma and how long it has been present. We provide several treatment options that are effective not only in reducing discomfort but also reducing the size of the neuroma over time. These include, custom orthotic inserts, therapeutic injections, special pads for taking the pressure off the nerve, exercises, footwear modifications and assessment and dry needling. Dr Azarian may also refer some cases for ultrasound guided injections and radifrequency treatment.
Surgery for removing Morton’s neuroma
Removal of the nerve (neurectomy) is reserved for large neuromas and chronic cases that are not responding to treatment. Dr Azarian will be able to advise you of your suitability for surgery and customise a plan accordingly.
The surgical removal is done under local anaesthesia with light sedation or under general anaesthesia at a day surgery hospital. This allows faster recovery and immediate weight-bearing. No crutches or casts are required.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. Call today for a consultation.