Morton’s neuroma refers to a nerve injury between the toes, usually the third and fourth toes, which causes pain and thickening of the nerve tissue. Compression or chronic irritation of this interdigital nerve is the main cause of Morton’s Neuroma. Excess pressure is exerted on the nerves due to narrowing of the gap between the toe bones causing thickening of the nerve tissue from scar tissue formation. This causes swelling of the nerve and the surrounding tissue.
Morton’s neuroma is more common in women than in men. The associated symptoms include:
- Burning pain in the ball of the foot (may also radiate to the toes)
- Numbness in the affected toes
- Inability to walk
Wearing high-heeled or narrow shoes squeezes the toe bones and worsens these symptoms.
Your doctor can diagnose Morton’s Neuroma by examining your foot. Palpation of the foot between the toes may reveal a thickened and tender area. A foot x-ray may be ordered to rule out other bone disorders.
Early treatment is critical to relieve pain. Mild to moderate cases of Morton’s Neuroma can be managed by conservative treatment. Severe cases of neuroma may require surgery.
The conservative treatment measures include:
- Resting your foot and application of ice packs over the inflamed area to reduce swelling.
- Anti-inflammatory medications to help alleviate pain and inflammation
- A corticosteroid injection may be performed if the symptoms do not improve with non-invasive treatments.
- Simple footwear modifications include using low-heeled shoes and broad toe box shoes with special pads to minimize discomfort between of the toes. Metatarsal pads and hapads are helpful to transfer pressure away from the ball of the foot. Stiffer soled closed back shoes or stiff sandals with a strap on the back also decrease loading through the forefoot.
- Physical therapy to relieve the pressure and improve the foot function. This is most helpful to improve calf flexibility and decrease forefoot loading.
Surgery is considered as the last option if in case the symptoms fail to resolve with the conservative treatments. Other indications include factors such as age and activity level of the individual, and extent of damage to the nerve.
Surgical treatment involves decompression (neurolysis) or resection of the involved nerve (neurectomy) or the surrounding tissue.
Neuroma ya Morton ni ugonjwa wa mishipa ya miguu ambayo huathiri mishipa ya miguu ya tatu na ya nne, na kusababisha maumivu na uvimbe wa tishu ya mishipa. Mshtuko au kuchochea kwa muda mrefu kwa neva hii ya kati ya vidole ndiyo kisababishi kikuu cha Morton's Neuroma. Mfumo wa shinikizo la juu hufanywa kwenye neva kwa sababu ya kupunguzwa kwa pengo kati ya mifupa ya kidole cha mguu, na kusababisha unene wa tishu ya neva kutokana na malezi ya tishu ya kidonda. Hilo husababisha uvimbe wa neva na tishu zinazozunguka. Ugonjwa wa Morton's neuroma ni wa kawaida zaidi kwa wanawake kuliko kwa wanaume. Dalili za ugonjwa huu ni kama vile maumivu ya moto kwenye mguu (yaweza pia kuenea kwenye vidole vya miguu) - Ugonjwa wa kutoweza kutembea - Kutokuwa na uwezo wa kutembea - Kuvaa viatu vyenye visigino vya juu au vidogo hufagia mifupa ya vidole vya miguu na kuharibu dalili hizi. Daktari wako anaweza kugundua ugonjwa wa Morton' s Neuroma kwa kuchunguza mguu wako. Kupima mguu kati ya vidole vya miguu kunaweza kuonyesha eneo lenye unene na lenye uchungu. Huenda ikawa ni lazima apime miguu kwa miale-X ili kuondoa magonjwa mengine ya mifupa. Matibabu ya mapema ni muhimu ili kupunguza maumivu. Matukio ya upole hadi ya wastani ya Morton' s Neuroma yanaweza kudhibitiwa kwa matibabu ya kihafidhina. Katika visa vikali vya neuroma huenda ikawa lazima afanyiwe upasuaji. Hatua za matibabu ya kihafidhina ni pamoja na: - Kupumzika mguu wako na matumizi ya pakiti za barafu juu ya eneo la uvimbe ili kupunguza uvimbe. - Dawa za kupambana na uvimbe kusaidia kupunguza maumivu na uvimbe - sindano ya corticosteroid inaweza kufanywa kama dalili haziboreshe na matibabu yasiyo ya uvamizi. - Marekebisho rahisi ya viatu ni pamoja na kutumia viatu vya visigino vya chini na viatu vya sanduku la kidole kirefu na pads maalum ili kupunguza usumbufu kati ya vidole vya miguu. Vipuli vya metatarsal na hapads husaidia kuhamisha shinikizo mbali na mpira wa mguu. Viatu vyenye sufu ngumu na vilivyofungwa nyuma au viatu vyenye mshipi mgongoni pia hupunguza mzigo kupitia mguu wa mbele. - Tiba ya kimwili ili kupunguza shinikizo na kuboresha utendaji wa mguu. Hii ni muhimu zaidi kuboresha kubadilika kwa ndama na kupunguza mzigo wa mguu wa mbele. Upasuaji huonwa kuwa chaguo la mwisho ikiwa dalili hazitashindwa kutatua na matibabu ya kihafidhina. Dalili nyingine zinatia ndani mambo kama vile umri na kiwango cha utendaji wa mtu, na kiwango cha uharibifu wa neva. Matibabu ya upasuaji huhusisha kuondolewa kwa shinikizo (neurolysis) au kuondolewa kwa neva inayohusika (neurectomy) au tishu inayoizunguka.