PLANTAR NEUROMA (Morton's Toe) |
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General Information
DEFINITION--A small benign tumor in the nerve that serves the 2nd, 3rd and 4th toes. It may affect one or both feet.
SIGNS & SYMPTOMS EARLY STAGES:
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Excruciating pain in the front part of the foot, particularly when running or bearing weight while jumping, turning or dancing. LATER STAGES:
Localized pain in the sides of the 3rd and 4th toes (usually). Pain occurs suddenly when least expected. Removing the shoe and massaging the painful area brings dramatic relief almost immediately. Pain is less when barefooted.
Tenderness at the base of the 3rd and 4th toes.
Feelings of electric shock or numbness running out into one or both toes.
CAUSES & RISK FACTORS
Relaxation of the ligaments of the foot causing thickening of the plantar nerve.
Ill-fitting shoes (possibly), particularly shoes used for athletic activity.
Repeated foot injuries.
Obesity and poor nutrition.
Recent or chronic illness.
If surgery is used for treatment, surgical risk increases with: smoking; use of drugs such as antihypertensives, muscle relaxants, tranquilizers, sleep inducers, insulin, sedatives, beta-adrenergic blockers or cortisone; use of mind-altering drugs, including narcotics, psychedelics, hallucinogens, marijuana, sedatives, hypnotics or cocaine.
HOW TO PREVENTUnknown.
WHAT TO EXPECT
DIAGNOSTIC MEASURES
Before surgery: Blood and urine studies; X-rays of the foot.
After surgery: Laboratory examination of removed tissue.
SURGERYNecessary to remove the neuroma if conservative treatment fails.
NORMAL COURSE OF ILLNESSTreatment with a metatarsal bar in the shoe usually relieves pain, although the tumor will remain until removed surgically. If surgery is necessary, allow about 3 weeks for recovery.
POSSIBLE COMPLICATIONSContinuous pain and partial disability if the tumor is untreated. Complications following surgery include excessive bleeding and surgical-wound infection.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
MEDICAL TREATMENTYour doctor may prescribe a trial treatment with a metatarsal bar in the shoe. If this fails, surgery will be necessary.
HOME TREATMENTAfter surgery, the foot will be snugly wrapped in a bandage. Keep the bandage dry and the foot elevated as much as possible during recovery. After removal of bandages, apply heat with soaks, tub baths or heat lamps. When healed, massage with ice for 10 minutes before and after vigorous physical activity.
MEDICATIONAfter surgery, your doctor may prescribe:
Pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need.
Antibiotics to fight infection.
Non-prescription drugs, such as acetaminophen, for minor pain.
ACTIVITYNo restrictions except those imposed by foot pain. After surgery, avoid vigorous exercise for 6 weeks. Gradually return to light activity after clearance from your doctor once the bandage is removed.
DIETNo special diet.
CALL YOUR DOCTOR IF
You have signs and symptoms of plantar neuroma.
Any of the following occur after surgery:
Pain, swelling, redness, drainage or bleeding increases in the surgical area.
You develop signs of infection (headache, muscle aches, dizziness or a general ill feeling and fever).
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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