Physical therapy of Morton's neuroma, Morton's syndrome, treatment, Vračar, Belgrade.

Morton's neuroma is a painful condition that affects the foot, specifically the area between the third and fourth toes. This disease occurs when the tissue around one of the nerves in the foot thickens, which can lead to pain, tingling and discomfort in the front of the foot. Although this condition is not life-threatening, it can significantly affect the quality of life and the ability to perform daily activities. Understanding the symptoms, causes, and treatment options for Morton's neuroma is key to timely intervention and alleviation of symptoms.

Morton's neuroma is a condition characterized by thickening and inflammation of the nerve between the toes, typically between the third and fourth toes. This thickening of the nerve, also known as a neuroma, can cause significant discomfort and pain, with symptoms often developing gradually. With each step, the feeling of discomfort can worsen, which can significantly affect the quality of life of those affected.

Symptoms of Morton's neuroma include:

Pain in the forefoot: The most common symptom is a sharp, stabbing, or burning pain between the third and fourth toes.

Tingling or numbness: Patients often report a tingling or numbness in the forefoot, which may be accompanied by a sensation of pins and needles in the toes.

Feeling of a foreign object: Some people describe a sensation of having a pebble or lump in their shoe, which can cause additional discomfort while walking.

Worsening symptoms with tight shoes: Symptoms of Morton's neuroma often worsen when wearing tight shoes or high heels, while pain may ease when removing shoes or massaging the foot.

• Narrow footwear during specific activities
• Excess weight
• Foot deformities
• Injuries and trauma

Morton's neuroma is a condition that can be triggered by various factors, and while the exact cause is not always completely clear, several key factors can contribute to its development. Understanding these causes can help in preventing and early detection of the condition.

Narrow footwear during specific activities: Activities that involve repetitive movements and intense pressure on the forefoot, such as running, jumping, or standing on the toes for extended periods, can increase the risk of developing neuroma. These activities can place additional stress on the nerves between the toes, leading to thickening and inflammation.

Excess weight: Overweight individuals may experience increased pressure on the feet, which can exacerbate stress on the nerves between the toes and contribute to the development of Morton's neuroma.

Foot deformities: People with foot deformities, such as flat feet (pes planus) or high arches (pes cavus), are at a higher risk of developing Morton's neuroma. These deformities can cause uneven distribution of pressure on the foot, leading to increased stress on the nerves between the toes. Such deformities can worsen symptoms and increase the likelihood of developing neuroma.

Injuries and trauma: Foot injuries, including sprains, strains, or direct trauma, can contribute to the development of Morton's neuroma. Injuries can cause inflammation or damage to the nerves, resulting in thickening and irritation. Trauma can further increase the risk of neuroma, especially if the foot is not properly treated or if activities that stress the injured area are continued.

Treatment for Morton's neuroma depends on the severity of the symptoms and their impact on quality of life. There are several approaches, ranging from conservative methods to surgical interventions.

Conservative Treatment

Wider toe box: Wearing shoes with a wider toe box can reduce compression on the nerve and allow the foot to expand naturally, thereby reducing the pressure causing pain.

Low heel: Shoes with low heels help balance the load and reduce pressure on the forefoot. High heels can exacerbate symptoms, so it is advisable to wear shoes with flat or low heels.

Orthotic inserts: Specially designed inserts that support and distribute the load evenly can help alleviate Morton's neuroma symptoms. These inserts may include cushioning pads or adjustable arches to reduce pressure on the nerve.

Stretching exercises: Stretching the muscles and tendons of the foot can help reduce tension around the nerve. Exercises focusing on the calves, Achilles tendon, and plantar fascia can be beneficial.

Strengthening exercises: Strengthening the muscles of the foot and ankle can improve foot stability and reduce pressure on the nerve. Exercises such as toe raises and walking on tiptoes can enhance foot function.

Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen or naproxen can help reduce inflammation and pain, alleviating symptoms and improving quality of life during treatment.

Corticosteroid injections: In some cases, doctors may recommend corticosteroid injections into the area around the nerve. These injections can provide short-term relief by reducing inflammation and pain.

Surgical Treatment

If conservative methods do not provide satisfactory results and symptoms persist or worsen, surgical options may be considered:

Nerve decompression: This procedure involves relieving pressure from the nerve by removing structures that cause compression. This can reduce pain and improve foot function.

Neuroma excision: If other methods fail, the removal of the neuroma may be considered. This surgical procedure can provide long-term relief from symptoms, but there may be changes in sensation in the forefoot due to the removal of nerve tissue.