All You Need To Know About Morton's Neuroma

Morton’s neuroma is a painful condition of the foot usually affecting the area between the third and fourth toes.  Patients usually complain as if they are stepping on a pebble in their shoe. This is due to a thickening of the tissues around the affected nerve, because of constant irritation, pressure or injury to the nerve of the toes, which can cause sharp burning pain around the balls of the foot.

Symptoms:

•  A feeling as if there is a pebble in your shoe.
• Numbness or tingling sensation in your toes.
• Burning pain in the ball of your foot that can radiate to your toes.

Who are at risk?

• Wrong footwear– wearing high heels is an obvious risk, not only does it cause Morton’s neuroma, high heels can cause all sorts of foot problems.
• Sports that are stressful to the feet like sprinting, running, foot ball, etc. Also, certain sports that require the use of tight shoes like rock climbing or skiing.
• People with foot deformities like flatfeet, high arches, bunions and hammertoes have higher risk of developing this type of neuroma.

Treatment

The treatment of Morton’s neuroma depends on the severity of symptoms,  conservative treatments are usually given as an initial approach.

Non-invasive treatments

• Foot pads and arch support are initially used to reduce pressure to the nerve.
• Injection of steroids into the affected area can be helpful for some patients.

Invasive treatments

• Decompression surgery. This is done by removing some structures surrounding the nerve growth like ligaments to relieve pressure.
• Removal of the nerve is necessary if all treatment fail to provide relief. Unfortunately, this may lead to permanent numbness to the affected toes.

What Is Plantar Fasciitis?

Our feet are probably the most used but most ignored parts of our body. During the day, an average person will spend about 12 to 14 hours on his/her feet. Because the feet are used so much in daily activities, it is not surprising that the feet may become injured from time to time. Approximately 75% of people around the world suffer from foot pain at some stage in their lives. Foot pain can really affect a person’s daily activity. One of the most common cause of foot pain is plantar fasciitis.

The plantar fascia is a thick band of fibrous tissue found underneath the foot. It attaches to the calcaneous bone or heel bone to the metatarsals for the feet. It is responsible for maintaining the arch of the foot and acts like a shock absorber. Plantar fasciitis occurs because of extreme stress to the foot, causing micro injuries to the plantar fascia, making it inflamed and tender causing mild to severe foot pain.

Symptoms

•  Pain is worst when taking first steps after long rest like taking the first step when getting out of bed in the morning or after a long drive.
• Pain is felt underneath the foot
• Pain lessens upon using the foot, but pain may then gradually increase.
• Resting eases the pain
• Stretching the underside of the foot can be painful

Causes

• People who are runners, sprinters or engaged in any sport that involve tremendous stress to the foot
• Obese people commonly have plantar fasciitis
• The use of wrong footwear

Treatment

• Rest – resting the foot is the primary goal in treating plantar fasciitis. This allows the micro injuries to heal. Depending on the severity, it will take a few days to several months to treat plantar fasciitis.
• Ice - applying cold stimuli can help reduce pain and swelling.
• Compress – applying an elastic bandage help decrease the swelling and it immobilizes the foot for faster healing
• Elevate – elevating the foot above the heart is a good way to reduce swelling. This will prevent pooling for fluids to the affected foot.

Common Causes Of Heel Pain

Plantar fasciitis is the most common cause of heel pain. This is due to the inflammation of the plantar fascia, a strong fibrous tissue found underneath the foot and connects to the calcaneus or heel bone to the metatarsals of the feet. 

If you experience heel pain when you take your first steps in the morning of after standing for long periods of time, then probably plantar fasciitis is the most probable cause. Plantar fasciitis also causes arch pain.

Heel spurs which are abnormal growths or protrusions of bone on the bottom of the heel bone, may cause foot pain when walking or standing. Heel spurs are commonly seen in people who suffer from plantar fasciitis, but heel spurs do not cause plantar fasciitis. If you have high arches or flat feet, then most probably you are suffering from heel spurs.

A fracture of the heel bone is most often caused by high impacts to the heel, typically a fall from high ground. Pain, swelling, bruising, limping and difficulty walking are all signs of a fractured foot.

A stone bruise is due to bruising of the fat pad of the heel. This occurs after stepping on a pebble or a small stone or any hard object. The heel may not change color  after the bruise. Pain reduces and disappears with rest.

Heel Pain Treatments

For Plantar fasciitis: RICE method

1.       Rest

2.       Ice

3.       Compress

4.       Elevate

For heel spurs:

1.       Custom made inserts

2.       Cut out heel pads

3.       Pain relievers

4.       Rest

5.       Surgery

For heel fractures

1.       Rest

2.       Padding or casting of the heel

3.       Pain relievers

4.       Surgery