At least once a week, I have a patient that comes to our Northern NJ office with the complaint of a neuroma in his or her foot. How do they know? They read it on the internet or their next door neighbor told them. Although not uncommon, these are typically misdiagnosed. I also have patients referred by their primary doctor with a referral for treatment of this condition. After a thorough examination, I find about 10% of patients to actually have a neuroma.
What Exactly Is Morton’s Neuroma?
A neuroma and specifically a Morton’s neuroma is found between the middle toe and the toe next to the pinky toe. It is located on the bottom of the foot where these toes meet the foot. You can have a neuroma anywhere on the body but typically, in the foot, it is in this location. This is a Morton’s neuroma.
A neuroma is a pinched nerve that has had micro-trauma for a long time. The outside lining of the nerve thickens and because of its location the pressure begins to cause symptoms. This is not a tumor. Because the structure of the nerve has gotten larger and the space it occupies remains the same, outside pressure causes the nerve to change its normal function.
In 27 years of practice I found one legitimate neuroma under the great toe, one on top of the foot and a third on the side of the ankle. All the others were Morton’s neuromas. I could discuss legitimate in person if you need explanation.
The Complaints Vary, But Are Not Limited To The Following …
Most people that come in for what they think may be a neuroma come in for inflammation of a joint near the area. This typically is swollen and much more painful than a neuroma. The treatment for these two entities is completely different. Some patients begin to treat themselves based on their Google search and come in after causing more problems because of incorrect treatment.
It takes years of practice to differentiate these two pathologies and some people never learn the difference. Most of the time, the patient receives a cortisone injection. This may work for one problem and not for the other. Many times the patient has an inappropriate procedure performed.
The cause of the neuroma and the joint inflammation is poor shoe fittings. When one continues to ignore the discomfort created by their shoes, they will likely cause a chronic problem.
If you think you may have pain from what you were told may be a neuroma, you should have an expert evaluate your foot and give you advice.
