High heels, intensive sport, foot anatomy … The causes of Morton’s neuroma are multiple. Dr. Cyrille Cazeau, orthopedic surgeon, explains how to recognize symptoms, avoid worsening and when surgery becomes inevitable.
A frequent but often poorly identified pathology
Morton syndrome, also called Morton neuroma, mainly affects women around 50 years old. It is a compression of a sensitive nerve of the foot, housed between the heads of metatarsians, most often between the third and the fourth toe. The thickened nerve forms a sort of painful bulge.
“”It is not a cyst or a tumor “specifies Dr Cyrille Cazeau. “”It is an inflammed nerve which grows by dint of being compressed in too narrow space. This causes pain that can be very intense, especially when walking with tight shoes“.
The causes of syndrome are multifactorial: high heels, repeated efforts, impact sports (such as running), foot malformations or simply an unfavorable anatomy. “It also happens that the scar tissue around a nerve, after a shock or a microtrauma, aggravates compression“Note the specialist.
Dazzling and disabling pain
Morton neuroma generally manifests itself by acute pain in front of the foot, often described as an electric shock or a needle planted between the toes. These sensations can radiate towards the ankle and are accompanied by numbness.
“”What is very characteristic is that the pain often obliges the patient to stop, to remove his shoe, sometimes even to massage his foot in the street “describes Dr. Cazeau. He adds: “Symptoms decrease or disappear when you are bare or lying foot, which sometimes allows a fairly reliable self-diagnosis. “
To establish a formal diagnosis, palpation in office remains a very revealing first index. Then, an MRI is generally prescribed, although some small neuromas go unnoticed to imaging. “”If the clinical examination is very evocative but the MRI is negative, that does not mean that there is nothing “specifies the surgeon.
How to treat Morton neurrome without surgery?
Fortunately, there are non -invasive solutions before going to the operating room. The first advice? Change shoes. “”We must abandon the high heels and opt for wide and flexible models, which reduce pressure on metatarsians “recommends Dr Cazeau.
In addition, the tailor -made orthopedic soles, designed by a podiatrist, allow the painful area to be unloaded. Anti-inflammatory drugs or the application of ice can punctually relieve crises.
But if pain persists, cortisone infiltration can be effective. “”An anti-inflammatory system is injected directly at the level of the compressed nerve. This sometimes makes it possible to avoid the operation“Explains the doctor.
When should you consider surgery?
If conservative treatments fail, surgery becomes the only sustainable option. It consists of removing the neuroma by making an incision of 2 to 3 cm on the top of the foot.
“”It is a short gesture, often made on an outpatient, under local or locoregional anesthesia “, reassures Dr. Cazeau. “”But beware, like any nervous surgery, there may be sensitive sequelae, even if pain relief remains very frequent “.
The follow -up requires a few days of rest, a temporary stop of physical activities, and shoes suitable for healing. A normal recovery of walking is generally possible quickly, but wearing high heels remains not recommended after the intervention.