Written By Roger Morelli
Brisbane Myotherapist and Remedial Massage Therapist
A Morton’s Neuroma is a class of nerve irritation known as a perineural fibrosis (swollen, inflamed and damaged).
It is a painful condition affecting the ball of the foot. Morton’s Neuroma pain is most likely to flare – along with associated numbness and tingling from walking.
A Morton’s Neuroma occurs when the sheath surrounding the nerve of the toes thickens from repetitive trauma such as over stretching/loading and compression.
In the majority of cases – the nerve irritation occurs between the 3rd and 4th toes, the primary demographics for this condition are middle-aged people - women are particularly susceptible to the symptoms of Morton's Neuroma.
Sharp, intermittent pain is the most obvious early symptom of Morton's Neuroma. It is often described as “a burning pain in the ball of the foot” or “walking on a rock”.
As the fibrosis worsens, numbness, tingling and other sensory disturbance in the toes will become more aggravated.
It is possible for people to have no symptoms of a Morton’s Neuroma – while imaging reveals the presence of a fibrosis.
Morton’s neuroma is usually attributed to shoes that are too tight (compression) and or have high heels – high heels force high levels of force into the ball of the foot creating ideal conditions to compress the nerves of the toes. This type of footwear may cause a nerve irritation - a swollen, thickened nerve caused by pressure and nerve rubbing (neural friction).
Injuries can also cause change foot biomechanics, which may create neural swelling, thickening and friction.
In Brisbane, Myotherapy offers a number of solutions to Morton’s Neuroma pain.
Initially the emphasis will be on reducing Neural friction. This can be achieved by reducing tension in the long muscles of the toes (they are deep in the calf). Nerve glides have been shown to improve the blood flow in the nerves – reducing pain and improving function.
The medical literature confirms that Manual Therapy techniques such as Remedial Massage and Myofascial Release can be extremely potent at reducing neural tension and the symptoms of Morton’s Neuroma pain - simply by reducing muscle tension.
Low Level Laser Therapy can be used to alter inflammation and increase the healing responses of the nerves – resulting in a more rapid reduction of the symptoms Morton’s Neuroma.
Electro needling is profoundly effective at reducing numbness and improving blood flow to the nerves. Best responses are obtained by improving circulation in the nerves of the leg – such as the tibial nerve and the peroneal nerve. Studies indicate that participants may receive up to 3 months reduction in Morton’s Neuroma pain after an electro needling intervention – this is in accord with our observations of Morton’s Neuroma treatment.
Footwear modifications - consultation with a podiatrist is essential for severe Morton’s Neuroma symptoms. Metatarsal domes are shock absorbing bubble wrap for the ball of the foot – and they are extremely effective at reducing irritation in between the toes.
The use of ultrasound guided corticosteroid injections has been shown to have some benefit in short term pain relief.
It is possible to reduce long term symptoms of Morton’s Neuroma pain and numbness in a rapid fashion. Our Morton’s Neuroma treatment combines manual therapies, patient education, low level laser and electro needling.