A neuroma is a swelling or scarring of a small nerve that connects to two of your toes and provides sensation to these toes. The symptoms can come and go depending on activity, shoe style and even, weather. They consist of pain or numbness, usually affecting the 3rd and 4th toes, counting from the big toe. Any action that shifts the body weight onto the front of the foot, such as wearing high heels, climbing stairs and running, can make a neuroma worse. Some doctors will describe a neuroma as a nerve tumor. However, don't worry because neuromas are not cancer and will not spread to other parts of your body. It is an injury to a nerve, that occurs slowly, over a long period of time.
HOW DOES IT FEEL?
Neuromas frequently start as a numbness or tenderness in the ball of the foot. This is the area just behind the base of the toes. As the swelling increases, pain and strange sensations such as numbness, burning and tingling in the area can radiate out into the toes or back into the foot. The area may be hot or very swollen and, just as mysteriously, the symptoms can disappear and reappear. At first, the pain is only present when weight bearing in tight shoes. As it gets worse, spontaneous shooting pains, often like electric shocks, can be felt even when you're off your feet.
LET'S DO A TEST!
Your doctor will make the diagnosis relying on your history and description of the problem and the physical examination. There is a simple test to find a neuroma. The doctor will squeeze the area between the bases of the toes to see if it is sensitive. If a neuroma is present, the doctor, and sometimes you, will feel a "click", as the soft neuroma mass squishes out between the long metatarsal bones. You may feel the pain shooting out into your toes or back into the foot. This is called a Mulder's Sign, and is the diagnostic sign of the presence of Morton's Neuroma.
Finally, the doctor will do an x-ray to see if there are any other problems present. The nerve and neuroma are soft tissue and don't show on a standard x-ray. However, the doctor can tell if the metatarsals are close together and if the toes are spread apart-both signs of a neuroma. If the diagnosis is at all unclear, a soft tissue imaging technique called an MRI may be done to actually see the neuroma mass.
HOW DID THIS HAPPEN?
To understand why neuromas develop, it is important to know how the nerves connect to the toes. The nerve that carries sensation signals back from the toes starts in the midfoot between the metatarsals. The nerve passes beneath a strong ligament, or soft-tissue band, that holds the metatarsal heads together. Just after it passes this band, it splits in half forming a Y. Each half then connects to the adjacent sides of the two toes.
The neuroma usually develops just under or beyond the tight ligament. Why? Well, imagine that the nerve is the bow of a violin and the tight ligament is the string. The constant pulling of nerve over the ligament irritates the nerve and causes the nerve to thicken and scar. The nerve also can get pinched between the two metatarsal bones that it passes between. A scarred nerve doesn't carry signals well and may send back strange signals to the brain such as burning, pain and tingling. So, instead of beautiful music, we get terrible noise.
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The Mortons Toe, or Why You Really Hurt: It All Starts In The Footby themortonstoe18,325 views
can a neuroma just dissapear? I was diagnosed several years ago, it bothered me from time to time, but not enough to go back to the dr. I just changed my shoes or my activities. I recently had an mri and was told there was no eveidence of a neuroma. Could it have been missdiagnosed or could it be hidden by swelling from another injury? Could the oxycodone I took the night before have shrunk the neuroma enough that it didn't show up? I'm very confused can you help me figure out what is going on?
purity4all 8 months ago
I am not sure if I have Morton's Neroma.
My pain is under my 2nd toe but I think it has shifted from my 2nd and 3rd toes.
I have had this for over a year now.
baristaman42 2 years ago