Morton Neuroma, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

Morton’s Neuroma (inter-digital neuralgia) is a medical disorder which causes pain in the forefoot especially in between the digits.
A neuroma is a benign tumor of a nerve.
Morton's neuroma is not exactly a tumor, but a thickening of the tissue that covers the digital nerve leading to the toes.
Morton neuroma is damage to the nerve between the toes, which induces thickening and pain.
It most often involves the nerve between the third and fourth metatarsal bones, producing pain and numbness in the third and fourth toes.
It can also involve the nerve between the second and third metatarsal bones, producing symptoms in the second and third toes.
Morton's neuroma seldom involves the nerve between the first and second, or between the fourth and fifth, metatarsal bones.
The cause is due to perineural fibrosis of the planter nerve where the medial and lateral planter branches of the nerve join.
The fibrosis is probably due to repeated injury of the nerve resulting in a painful fusiform swelling of the nerve.
Morton's neuroma happens as the nerve passes under the ligament joining the toe bones (metatarsals) in the forefoot.
The incidence of Morton's neuroma is 8 to 10 times higher in women than in men.
Females are normally involved because of the shoe wear. (High heel tight shoes)
The following may play a part in the formation of this disorder:
1. Wearing tight shoes and high heels
2. Abnormal positioning of toes
3. Flat feet
4. Forefoot problems, including bunions and hammer toes
4. High foot arches
Morton Neuroma is thought to form as a result of long-standing (chronic) stress and irritation of a plantar digital nerve.
1. Some thickening (fibrosis) and swelling may then develop around a part of the nerve.
2. This can look like a neuroma and can lead to compression of the nerve.
Symptoms:
If the patient sometimes senses that he or she is "walking on a marble," the patient may have Morton's neuroma
1. Severe burning pain in the region of the third web
2. Pain may spread to the third and fourth toes
3. Pain is exacerbated by tight shoes
Diagnosis:
1. During the examination, the doctor will feel for a palpable mass or a "click" sound between the bones.
2. He or she will put pressure on the spaces between the toe bones to try to induce the pain and look for calluses or proof of stress fractures in the bones that might be the source of the pain.
There is tenderness on digital pressure between the third and fourth metatarsal heads
Compression of the forefoot transversely also produce the same pain
3. The range of motion tests will exclude arthritis or joint inflammations.
4. X-rays may be needed to exclude a stress fracture or joint arthritis that joins the toes to foot
5. MRI or ultrasound can successfully detect the condition
Treatment:
1 Surgical removal of neuroma or decompression of the nerve is often essential.
2. Local injection of lignocaine and steroid may relieve the pain.
3. Tight fitting shoes should be avoided
The doctor may advise any of:
1. Padding and taping the toe area
2. Shoe inserts or orthoses
3. Changes to footwear, such as wearing shoes with wider toe boxes or flat heels
4. Anti-inflammatory medicines taken by mouth or injected into the toe area
5. Nerve blocking medicines injected into the toe area
6. Other painkillers
7. Physical therapy
8. Anti-inflammatories and painkillers are not advised for long-term treatment.
9. In some patients, surgery is needed to remove the thickened tissue and inflamed nerve.
This helps alleviate pain and improve foot function.
10. Numbness after surgery is permanent.
11. Cryotherapy may help

TABLE OF CONTENT
Introduction
Chapter 1 Morton Neuroma
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7

• Language: English
• Publisher: Kenneth Kee
• Release date: Sep 13, 2017
• ISBN: 9781370267569

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Morton Neuroma,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2016 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes the Morton Neuroma, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Morton Neuroma)

This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Conditions into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical conditions.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring you the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Morton’s Neuroma

What is Morton’s Neuroma?

Morton’s Neuroma (inter-digital neuralgia) is a medical disorder which causes pain in the forefoot especially in between the digits.

A neuroma is a benign tumor of a nerve.

Morton's neuroma is not exactly a tumor, but a thickening of the tissue that covers the digital nerve leading to the toes.

Morton neuroma is damage to the nerve between the toes, which induces thickening and pain.

It often involves the nerve that travels between the third and fourth toes.

It is a disorder that involves one of the common plantar digital nerves that run between the long bones (metatarsals) in the foot.

It most often involves the nerve between the third and fourth metatarsal bones, producing pain and numbness in the third and fourth toes.

It can also involve the nerve between the second and third metatarsal bones, producing symptoms in the second and third toes.