Morton’s Neuroma and foot health

Living in Florida can be hard on your feet. Warm weather kind of tempts Floridians to indulge in bare feet or scarcely dress in cool ill-supported flip flops. But taking care of the health of our feet is vital to maintaining a healthy lifestyle.

Discussions of foot health often focus on shoe support. Many remember growing up with conversations about flat support contributing to falling arches or high-heeled shoes causing bunions or constricted nerves.

Certain conditions are prevalent today in discussions of foot health, particularly as we age. Awareness is almost always the key to finding solutions or, at the very least, coping mechanisms for foot issues.

According to the National Institute of Health, Morton’s neuroma is a condition defined as the thickening of the nerve tissue in the ball of the foot that might be attributed, at least in part, to compressing and irritating the nerve of the foot.

Morton’s neuroma is an injury to the nerve between the toes, causing thickening of the tissues and resulting in pain. Morton’s neuroma commonly affects the third and fourth toes.

Dr. Jude-Farley Pierre, DPM, of Access Health Care, said that many of his patients who suffer from Morton’s neuroma typically experience the sensation similar to walking with a pebble in their shoe when none exists.

“It is inflamed nerve tissue,” Pierre explained, that typically affects the area between the first and second or third and fourth toes. “And it can be very painful.”

Patients might experience tingling or the sensation of electricity running through their toes. “The pain might shoot up toward the toe or down toward the ankle,” he said.

The National Institute of Health described the following symptoms of Morton’s neuroma as follows:

• Tingling between the third and fourth toes

• Toe cramping

• Sharp shooting or burning pain in the balls of the feet

• Pain that seems to increase when wearing shoes or when pressing the area

• Pain that seems to increase over time

Ironically, Dr. Pierre usually recommends that his patients who suffer from Morton’s Neuroma wear high-heeled shoes to elevate the feet.

“Often times the nerves run along the sides of the toes,” he explained. So elevating the foot inside heels often takes the pressure off the nerve.

Pierre described a few patients who have actually relieved their pain from walking in heels even though some experts believe high heels may contribute to the condition. He described on patient whose condition was exacerbated with flat shoes. Wearing heels helps alleviate the pain, she told him.

Diagnosis of Morton’s neuroma begins with a complete exam of the foot by a medical professional. Xrays of the foot is usually ordered to rule out any bones issues.

An MRI or high-resolution ultra sound can usually successfully diagnose Morton’s neuroma.

Once confirmed, treatments for Morton’s neuroma might include non-surgical solutions like :

• Padding or taping the area of the toe that is affected

• Shoe inserts

• Anti-inflammatory medicines

• Nerve-blockers injected into the affected area

• Physical therapies

In some cases, surgery might be recommended to remove the thickened tissue.

Dr. Pierre isn’t a fan of surgery for Morton’s neuroma, however. “Surgery could actually make it worse because we are talking about inflamed tissue,” he said. While the pain may be relieved by removing the tissue, numbness might occur for the rest of the patient’s life.

The tissue that is left behind could morph into stump neuroma, he added. “They often inject the area with steroids,” Pierre continued, “but sometimes the patient suffers for the rest of their lives. It may not be as severe but they still may have some issues going on.”

Instead, Pierre typically tries a series of other solutions including injection therapies to help relieve the problems without surgery. Cortisone is often used as an anti-inflammatory agent injected into the area.

He also injects a nerve obstruction agent. “It shrinks the nerve,” he said. “It might be a better outcome than the cortisone injections because we can give a lot more of them. But the drawback is that it is very painful.”

Dr. Pierre sees patients for various foot problems in addition to Morton’s neuroma including issues that stem from diabetes. “I see a lot of diabetic patients,” he said. “There are a lot of things that diabetes will affect and the feet are really crucial. If not cared for, they could lead to some kind of infection.”

He is also firmly against going natural with the feet, suggesting that, while not medically confirmed, going barefoot might actually contribute to Morton’s neuroma. It certainly can exacerbate the condition. In his opinion, it is more often a contributor than walking in high heels.

“Walking barefoot is never a good idea,” he said, “especially here in Florida. I don’t care what you’re suffering from, walking barefoot is horrible.”

Walking around bare foot can also lead to all sorts of other problems. “Many of my patients who walk around barefoot run into all kinds of issues,” he said, including splinters, warts and even the HPV virus that can cause Herpes.

Access Health Care is located at 3502 Mariner Blvd. For more information about Dr. Jude-Farley Pierre, visit his office or call him at (352) 666-1913.

Kim Dame is a correspondent for Hernando Today. She can be reached at [email protected].