An Overview Of Morton’s Neuroma
What Is Morton’s Neuroma?
Morton’s neuropathy or Morton’s neuroma is one of the commonest causes of forefoot pain.
Morton’s neuroma is a benign (non-cancerous) condition where one gets the symptoms of pain on the plantar aspect (sole) of the foot with associated pins and needles going into the toes due to one of the small nerves of the foot as a result of the nerve looking like a tumor or a bulb (like bulbs of a flower or the joint of fibreoptic cables).
Nerves are smooth long tubes like electric wires which conduct information from brain to tissues (muscles, skin, etc) and vice versa. Nerves are either sensory (which only take sensations to and from the skin to the brain), motor nerves (which only take information to & from brain to muscles and thus control muscle movements/ function) or mixed nerves which carry both sensory and motor fibers.
Morton’s neuroma is named after an American Professor of Surgery in Philadelphia (during American Civil War), Prof. Thomas George Morton.
Location of Morton’s Neuroma
Morton’s neuroma is commonly found in the third web space, (i.e. between the third and the fourth toe) followed by the second web space (between the second and the third toe). These are respectively 68% and 32% of cases in the literature.
Causes of Morton’s Neuroma?
Why does Morton’s Neuroma Develop in first place? Am I born with it? Is it because of my foot wear?
- One is that the third metatarsal nerve is anatomically thicker and is made by merging of the medial and lateral (inside and outside) plantar nerves.
- Second, the shearing forces that occur at the third web space are much more because the fourth metatarsal is more mobile compared to the third metatarsal
Also, it is possible that the second and third metatarsal spaces are narrower compared to the other metatarsal spaces, hence these two spaces are the most commonly found to have Morton’s neuroma
Symptoms of Morton’s Neuroma
Diagnosis Of Morton’s Neuroma
Regarding diagnostic investigations, ultrasound and MRI scan are the two most common modalities which are used to diagnose Morton’s Neuroma.