Similar and different to your pinch nerve in neck and shoulder,back or others expcept foot, a tumor formed in the intermetatarsal spaces of lesser toes, occuring mostly in middle aged women (78 %), causing painful burning and tingling sensation in the spaces between two affected toes are symptoms for Morton’s neuroma or plantar/ intermetatarsal neuroma. Rather than a true tumor, it is considered as the formation of fibrous tissues around nerve tissues. This condition was first correctly described by Durlacher, a chiropodist, in 1845. The condition is formed by compression of the nerves, most commonly in the 3rd (80-85%) intermetatarsal space and less commonly in the 2nd (15-20%). The pain felt is a shooting pain in between the two affected toes. In some cases the pain may be felt in the toes or may even radiate upto the leg. Pain generally reduces when shoes are not worn, and is worsened on wearing tight or high-heeled shoes as these increases the pressures on the intertarsal spaces. However, in some patients morton’s neuroma is asymptomatic and is diagonosed by Bone Scan or MRI Scan.
For its treatment while nerve pinching, Morton’s neuroma surgery called neurectomy should be considered a proper option if several non-operative treatment for the disease, like injecting Orthotics and Corticosteroids, wearing wider shoes or inserting something in them, thus reducing pressure, fails; or if typical symptoms last for more than 6months. But neurectomy is not suitable for patients with bad circulatory status, diabetes mellitus, or reflex sympathetic dystrophy. Neurectomy has a success rate of 80%, resulting in scar tissue/ stump-neuroma formation and thus return of neuroma symptoms post-surgery, in the rest 20% cases. Cryogenic neuroablation or destruction of the axons that carry painful impulses, by application of extremely low temperatures of -50 to -70degrees centigrade, is also an alternative.
The surgical procedure of the Morton s neuroma surgery involves incising between the two affected toes to expose the neuroma, identifying the Common Digital nerve and following it to the appropriate Digital nerve of the affected toe, separating it from the neuroma which occurs around it, then dissecting it free and excising it. The wound is then closed with absorbable suture. Patients can go home the same day, with Compressive Dressings, that is to be worn for 2weeks. Stiches are removed after around 10days; after that patients can start wearing broad and loose shoes. Since the stitches are not on the underside of the foot, pain is not felt while walking. In the history of medical science this kind of stich is very helpful.