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Dr. Thomas F. Bembynista
Morton's Neuroma Morton's neuroma is enlarged nerve that usually occursbetween the third and fourth toes, but a neuroma can also occur between thesecond and third toe.
The nerve lies in the subcutaneous tissue, just above the fat pad on the bottomof the foot between the metatarsal bones. The ground pushes up on the enlargednerve with each step causing the nerve to be pinched between the metatarsalbones causing pain. The nerve normally gets bigger from the pinching and increasesin pain as the problem gets worse. The most common symptom is localized pain between themetatarsal bones on the bottom of the foot. It can be sharp and is worsened byshoes or walking. Many time people have shooting or throbbing pain when they are off their feet. Usually it is easy, there is localized pain on the bottom of the foot. Commonly simply palpation to the area elicits pain when we hold the foot and push careful on the area which causes a audible click which is the nerve being pinched between the metatarsal bones. In most causes a mild steroid injection given 1 to 3 times over a few week period this can reduce the pain. If pain persists, chemical neurolysis injections can be used its generally very helpful but may result in slight numbness to the nerve area. In some cases custom orthotics can help also.
Surgery is rarely necessary ,The incision is made on top of the foot to prevent a bad scar on the sole of the foot this also allows for early weight bearing after surgery, this can be performed in the office or outpatient. Complications are rare, but the nerve can redevelop.
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Dr. Thomas F. Bembynista
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