Mortons Neuroma, which is also named plantar neuroma, mortons neuralgia, mortons metatarsalgia, is a benign tumour growing on a plantar nerve running between metatarsals 2/3 or 3/4.
Although it is labelled as a tumour, it is actually a fibrous tissue formation that grows around nerve tissue
Its symptoms are pain and numbness.
There is no obvious outward signs of mortons, but pressure placed inbetween the metatarsal heads at the site of the pain will elicit symptoms. I generally do this with the blunt end of a pencil.
Compressing the metatarsal heads together will also elicit the symptoms, and this is known as " mulders sign ". Often there is a click inbetween the metatarsals involved known as a " mulders click "as the bones click across the growth.
There is a number of operative procedures available for mortons, but these are not without the risk of return pain, as the foot posture problem that started it in the first place is still there.
From many clinical years working with mortons neuroma, I can very strongly say that this condition is caused by excessive pronation of the foot exerting pressure inbetween the metatarsal heads, irritating the nerve, and giving rise to the fibrous tissue growth that actually forms in an effort to protect the nerve !!
In the full realisation that these growths do not just land from outer space, this makes perfect sense.
The above is my theory, but having observed many mortons cases, and looking at the foot posture that gave the neuroma cause to grow, I see no other reason for its existence.
So, given that pronation is the underlying causative factor, it also makes perfect sense that prescription orthotics need to be worn for two reasons.
1/ To prevent a mild or small neuroma from exacerbating.
2/ If the neuroma has been deemed too severe, and been operated on, to avoid a return to either the same place, or to other heads on either foot.
If you go down the orthotic route, ensure your practitioner uses prescription orthotics ( The foot must be cast or laser scanned!!!) and a semi flexible shell is used, not rigid shell, which should only be used in exceptional cases.
A Les Bailey orthotics article.
Dr Les Bailey phd,DO,acopm,apta ( int part ) 2012
ABOUT DR LES BAILEY
Dr Les Bailey phd,DO, acopm.apta(int part )
Dr Les Bailey is author of "the laymans guide to foot and heel pain" and is a writer of numerous internet articles about physical therapy and osteopathy.
Direct phone 07801418080
Dr Les Bailey began in physical therapies in 1981,first qualifying in remedial massage,and later going on to qualify as an osteopath at the Northern school.
He gained his phd from OIUCM for his thesis on the treatment of plantar fasciitis.
He was awarded a teaching/lecturing diploma from the northern school of osteopaths in 1993.
He also holds the diploma in foot biomechanics .
Dr Les Bailey works from his clinic near Banstead in surrey.