Morton’s Neuroma – Toe and Foot Pain Sioux City
Burning, Tingling And Pain In The Toes Or Foot
Several different conditions can cause pain on the bottom of the foot, especially around the sole. One common condition is Morton’s neuroma, which classically presents as pain on the sole of the foot, occurring without any specific inciting incident. People deny walking or running any more than usual, and they notice less pain when barefoot. Some people feel more numbness or tingling in their toes, it may feel as if they “ hit their funny bone ”.
The sole of the foot is made up of many small bones that run longitudinally with transverse ligaments on the top and bottom of the foot. We have multiple muscles, tendons, nerves, and arteries running in between the bones. Irritation of the tendons, muscles, or ligaments causes inflammation and swelling to develop, which can compress the small nerves. Compression of the nerve is called a nerve entrapment and can cause pain, numbness, tingling, or burning in the nerve distribution. On the sole of the foot this is commonly caused by injury to the inter-metatarsal ligament, which runs across the metatarsals. The most common injury location is in between the second and third toes.
Sometimes a small mass can be felt between the metatarsals, representing a neuroma. A neuroma is an accumulation of material around the nerve fiber. As the tissue accumulates, it compresses the nerve, causing the familiar symptoms described above. Extension of the toes increases the pain numbness, tingling, or burning sensation, while flexion decreases the symptoms.
In these cases, a main aspect of treatment is protecting the affected area to reduce stress and strain. During evaluation, in some cases, x-rays can be used to rule out stress fractures or other injuries to the muscles, tendons, and ligaments.
At home, some patients feel relief when using temporary metatarsal pads, which reduce the stress and compression. Other patients may benefit from orthotics. Treatment goals are to decrease pain, numbness, tingling, and burning in the foot and toes. Treatment options include cortisone injections to decrease inflammation. Conservative therapy includes therapeutic modalities to decrease inflammation, including ultrasound, ice, heat, cold laser, and mobilization techniques. Severe cases may require surgical excision to remove the neuroma.
When people experience the numbness, tingling, or burning after a long hike or walk, we commonly recommend a few days of rest and wearing proper footwear. Many times, the tingling disappears after rest and ice. In these instances, we can safely say that the nerve was compressed by a simple strain. If the pain does not subside with a week of rest, ice, and treatment, then we would generally suspect a greater nerve entrapment, in which case office treatment may be required.