Mortons Neuroma Treatment Toronto Foot Clinic and Doctors

Mortons Neuroma Treatment Toronto 

 If you walk around Downtown Toronto in your dress shoes on a regular basis, you may be susceptible to a Neuroma.

What is a neuroma?

A neuroma is a type of metatarsalgia, which is a condition that impacts the balls of the feet. A neuroma is inflammation of a foot nerve. It is commonly found in between 3/4th webspace, however it can be found in other web spaces. The chief complaint is numbness, tingling, shock-like, or a burning sensation in the forefoot that radiates to the toes. It commonly affects middle aged women. It can be caused by factors including biomechanics, footwear and lifestyle. W

 

Signs and Symptoms of  Morton’s Neuroma 

Initially it may be hard to tell as some signs and symptoms of this condition can mimic other types of metatarsalgia. If signs and symptoms do not improve with rest and treatment, it is wise to see a doctor for an ultrasound and x-ray to rule out any other type of metatarsalgia condition. Typically one may feel like a sock is curled up, like they are stepping on a marble or electricity is jolting through their toes. 

 

Causes of Neuroma 

Forefoot conditions are multifactorial and usually due to a combination of factors that cause excessive pressure on the nerve. These factors include:

 

Thin Soled Shoes: The bones of the forefoot do not have a lot of padding under them. Excessive forces from pavement during walking and running can lead to forefoot injuries. 

High Heels : Cause pressure to be placed almost completely on the balls of the feet. This in combination with a thin, tight soled shoe is a recipe for foot pain to happen. 

Tight Shoes/ Narrow Toe Box : This causes the bones of the forefoot to squeeze together. This can lead to irritation of the nerve of the foot as well as predispose a neuroma injury. 

Biomechanical Imbalances : Foot function can cause excessive overloading of the 3/4th webspace. For instance a walking or running pattern that has a low gear toe off, means at the point of walking or running when the foot leaves the ground, the pressure is not through the ball of the big toe, but it is placed through the lesser digits. The ball of the big toe is larger than the little toes and is more susceptible to injury as these bones are smaller. Other issues such as tight calves, bunions , high arches and flat feet can all contribute to a neuroma. 

Tight Calves : Can contribute to excessive pressure on the balls of the feet. It can also cause abnormal gait patterns. 

High Impact Activities : Such as running and jumping places repetitive wear and tear on this area and are commonly associated with these types of activities. 

Treatment:

Having a proper diagnosis is a good place to start. This can be done by our Sport Medicine Doctor on site in Downtown Toronto. Typically an ultrasound will be paired with an Xray to ensure no bony injuries are associated. This is because sometimes other forefoot injuries can have similar symptoms to that of a Neuroma. 

Conservative Care: 

Footwear modification is an immediate protocol, wider toe box, supportive arch and well cushioned forefoot. 

Pointy shoes, high heels and tight flats are to be avoided. Metatarsal pads and orthotics can help reduce pain on the forefoot but spreading the bones apart, reinforcing the forefoot arch and preventing the balls of the feet from pressing directly into the ground. 

 

Injection Therapy 

Corticosteroids are a regular type of injection choice for a neuroma. This can be done at our clinic with ultrasound guided injection therapy, which is more accurate than done without. Ultrasound allows to more accurately inject right into the neuroma and not inject into the transverse ligament, which is a very important ligament to the foot structure. Corticosteroid can cause a risk of rupture, so avoiding that ligament is of extreme importance and less likely to hit with the ultrasound guided injections. 

Sometimes multiple injections are required, no more than 3 per calendar year and with adequate time between. 

Surgical interventions 

If conservative care, corticosteroids and orthotic management, then surgical interventions are an option. 

This treatment will permanently kill the nerve, with side effects of desensitization, numbness being left as a side effect of surgery.  

 

If you or someone you know is suffering from a Morton’s Neuroma, here at InStride Downtown Toronto Podiatrist, Partner of LiveActive Sport Medicine , we would be happy to help. 

Author:

Laura Desjardins is a registered chiropodist who treats neuromas of the foot in Downtown Toronto.

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