Non-operative treatment of morton’s interdigital neuroma with a foot orthosis

Lorenzo Brognara,Simone Santarini

doi:10.15406/ijrrt.2018.05.00165

Abstract

Morton rsquo s neuroma is a frequent cause of forefoot sharp pain associated with a burning sensation and paresthesias Histologic findings of Morton s neuroma include perineural fibrosis of intermetatarsal nerve Conservative measures are indicated to relieve symptoms and can also increase the gait parameters that require good function of the forefoot For this study we chose to use a drop shaped metatarsal pad and a silicone orthosis which are both found to be beneficial in treatment of Morton rsquo s Neuroma The ultrasound image showed the disappearance of the anechogenous irregular area between third and fourth metatarsal head of left foot We have demonstrated that the use of a ultrasound machine is a feasible alternative to conventional processes to validate the foot orthoses The importance and originality of this study is to show a new effectiveness evaluation approach for the orthotic insoles Patient reported benefit from foot orthosis both during sport activity and in everyday life

Highlights

Morton’s Neuroma is a relatively frequent cause of foot pain that can be characterized from both, pain similar to an “electric shock” and burning sensation, generally, at the intermetatarsal space
The aim of this study is to verify whether a foot orthosis, besides helping treatment and rehabilitation of the primitive pathological deformities, can reduce symptoms in Morton’s interdigital Neuroma.[1,2,3,4,5,6,7,8,9] each activity with the need to massage the interested zone
The above-mentioned clinical case pointed out a pain improvement referred by the patient just after 4 months from the plantar and fingers orthotic therapy performed by the podiatrist

Summary

Introduction

Morton’s Neuroma is a relatively frequent cause of foot pain that can be characterized from both, pain similar to an “electric shock” and burning sensation, generally, at the intermetatarsal space. The interdigital plantar nerve, in the area of the metatarsal heads, is often the most affected and it is a common cause of foot pain It is most probably a mechanically induced degenerative neuropathy which has a strong predilection for the third common digital nerve, especially in middle-aged women. It is possible to recognize the presence of perineural fibrin and hypertrophy of the interdigital nerve associated with a possible edema. The causes of this pathology can be traced back to traumatic factors and to biomechanical factors, due to the onset of deformities such as flatfoot, and/or to insufficiency of the first ray. A reduced sensitivity at the level of the third and fourth ray of the left foot has recently appeared

Objectives

Conclusion