Morton’s Neuroma: Symptoms & Treatment

Morton’s neuroma is a medical condition affecting one of the many nerves running between the metatarsals in our foot. Metatarsals are one of the many bones found in the foot. The other bones are the tarsal bones and phalanges with metatarsals being the longest ones. There are a total of five metatarsal bones and the first is the largest and the smallest is the last.

Morton’s neuroma is named after a doctor who first described this condition in 1876 – Dr Morton. It affects the plantar digital nerves running between the metatarsals and usually affects the third and fourth bone. It may also affect the second and third metatarsal bones but this is less common and rarely affects the first and second and fourth and fifth.

Patients suffering from Morton’s neuroma often complain of pain that starts in the ball of the foot all the way to the affected toes. Some patients however will brush it away as toe pain. In some cases, a stinging sensation might also be felt in the toe. The pain will also be felt at the sides of the affected toes. For example, if the third and fourth metatarsal bones are affected, pain will be felt at the right side of the fourth toe and all the way to the left side of the third tone. Symptoms are intensified if patients wear high heel shoes requiring them to walk on their toes and will often go after periods of rest.

Some patients require simple non-surgical treatments while some may need surgery:

Non-surgical treatments

  • Footwear adjustment might be all that is needed for some patients. This include wearing wide feet shoes to allow room for toes to wriggle, avoiding high heel shoes and having orthotic pads fitted into the shoe.
  • Cryotherapy uses extreme cold to destroy neuroma tissues. Through the use of liquid nitrogen, it effectively shrink tissues and inhibit blood flow to the abnormal tissues.
  • Steroid injections will deliver a burst anti-inflammatory medication directly to the area
  • Sclerosant injections delivers a mixture of alcohol and local anaesthesia to shrink blood vessels and some doctors compare the effectiveness of it to surgery

If non-surgical treatment does not help, surgery will be required. The main purpose of surgery is to make space for the affected nerves due to decompression. The surgeon will make a small incision at the top or sole of the affected foot to relieve the internal pressure. The success rates of surgery is high and long term complications are not common.

 

Questions To Ask Before Orthopaedic Surgery

Orthopaedic surgeries are major surgeries and are extremely stressful. There will be a lot of doubts going through your head and can trigger an anxiety breakdown. However, this can be controlled by asking questions prior to your surgery. Being knowledgeable about what you are about to go through will allow you to appreciate the entire surgical process, prepare yourself for it and set in mind a proper recovery plan post surgery. So what are some questions that you should be asking your surgeon before surgery?

Why am I doing this surgery?

It is easy to Google online for information regarding the particular surgery you are about to undergo. However, there is no clear answer to why you are doing the surgery. You should be asking your surgeon why he recommended this particular surgery for you and are there any other alternative treatment methods that are available as well as a comparison between the possible alternatives. This will allow you to have a high confidence level prior to surgery.

What are the risks?

Risks are inevitable in any surgery and some carry a higher risk level than others. It would be good to clarify on this issue as well as question about some surgical procedures which have lesser risk level such as the use of a local anaesthesia as compared to a general anaesthesia as studies have shown that patients who received general anaesthesia have a higher risk of post surgery bleeding.

What are the available pain relief methods?

Pain and discomfort is also unavoidable post surgery and some people have a lower pain threshold than others. Therefore, it is crucial to understand about the available pain relief methods which will help you get through this tough period. You should also know what medications you are allergic to so that proper medication can be administered to you.

What are the success rates?

Bluntly speaking, you undergo surgery with the hope that it is a success. However, as you have already known, some surgeries carry a higher risk factor than others and therefore the success rates will fluctuate. Knowing what the success rates are will allow you to make better plans for your future.

No matter what orthopaedic surgery you are about to undergo, you should always ask questions prior to it to clarify your doubts and set your mind at ease. Here’s wishing you to a successful surgery and quick post-surgery recovery.

Spine Surgery: Orthopaedic Surgeon or Neurosurgeon?

In the event that you require spinal surgery to cure your injured back, the first and most important decision you have to make is to choose between an orthopaedic surgeon or a neurosurgeon. The choice of the right surgeon is extremely important and you have to consider factors such as the experience and success rate of the surgeon. So how different are these 2 doctors?

You will first need to understand that both are able to carry out spine surgery. In the past, neurosurgeons were the only ones that could qualify to perform spine surgery. With the evolution in medical techniques, orthopaedic surgeons are well equipped with the knowledge and skills to carry out spine surgeries for patients as well.

Neurosurgeons are medically trained doctors who have completed at least a 4 to 7 years worth of gruelling neurosurgery residency. Neurosurgeons specialise in disorders affecting the nervous system including the brain, spinal cord and nerves. There is however one distinct part that sets them apart from orthopaedic surgeons. Neurosurgeons are the only people who are able to perform surgery that is inside the dura mater of the spine. If the patient has a tumour in the spinal cord, cysts or spinal cord malfunction, only a neurosurgeon is able to perform the surgery for him.

Orthopaedic surgeons on the other hand are medically trained doctors who have completed a 5 years surgical residency focusing on musculoskeletal disorders such as the bones and joints. Most orthopaedic doctors focus on sports injuries and bone disorders. Some orthopaedic surgeons will choose to focus on spinal injuries and they will have to spend additional few years of their time to complete fellowship training on the spine. Other than the few specialised surgeries that only a neurosurgeon can carry out, orthopaedic doctors are able to carry out other spinal surgeries.

When choosing a surgeon to perform spinal surgery for you, the main question is not to decide on whether an orthopaedic surgeon or a neurosurgeon since both are equally adept to perform the surgery. Instead, you should be asking what is his specialisation. Some are specialised in cervical spine surgeries while some are inclined to lumbar disorders. The important questions you would want to ask is how many similar surgeries have they performed to date and what are the success rates. Spinal surgery being a major surgery, you would want a very experienced surgeon to perform it on you.