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Competencies

Morton’s Neuroma

Неврома Мортона

General information

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formation of a fibrous tissue around the twig of the plantar nerve. It is common in women over 50 and it has a unilateral character. Usually it can be found in the third, second and fourth intermetatarsal spaces. However, there are a lot of other causes of biomechanical obstructions which lead to nerve irritation and as a consequence to Morton’s neuroma: modifications in the nerve structure, adipomes, inflammation of bursae, etc.


Symptoms

The most common symptoms are pain, paraesthesia spontaneously occurring abnormal tingling, burning sensations) and numbness in the region of nerve compression, most commonly at the head of the third, fourth and second toes. Pain can radiate (extent) to the toes. Symptoms can increase or decrease over the years and they can exacerbate because of tight footwear. Pain can be reduced once the shoes are taken off. Massaging the painful spot can also help.

Diagnostics

It is based on medical history, clinical implications, palpation and instrumental diagnostics (ultrasonography, MRI scanning) if necessary. The pathognomonic feature is a sharp increase in pain upon lateral compression of feet and also flicking sounds upon simultaneous palpation of intermetatarsal spaces. Temporary relief from local anesthetics helps determine the location of Morton’s neuroma.

Conservative treatment

Patients are recommended wearing loose low heel shoes in order to reduce mechanical factors. To relieve pain and local inflammation non-steroidal anti-inflammatory medications are used. Use of steroidal injections along with local anasthetics into the area of Morton’s neuroma is also possible. We don’t recommend anybody treating the disease using folk medicine.

Surgical treatment

If conservative treatment doesn’t help, surgical treatment is needed. It implies incision of perineural fibrosis. Upon incision of the part of a nerve with neuroma, there can appear slight numbness. Thanks to minimally invasive and traumatic surgical technics, the patient recovers on the next day after the surgery and gradually increases load on the foot as pain and swelling go away.

Prognosis

According to foreign and national publications of the last twenty years, conservative treatment is successful in 20-30% of cases and surgical treatment in 75-85%. Our experience show that efficiency of surgical treatment is higher – 95%.


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