| Neuromas
and Nerve Tumors |
|
.Morton's
Neuroma |
| A
unique type of "neuroma" is
the so-called Morton’s "neuroma."
Morton’s neuroma is not a true
neuroma, and yet it is commonly treated
as one. |
Why
is Morton’s neuroma not a true
neuroma?
|
The
pain caused by the Morton’s neuroma,
medically described as metatarsalgia
(pain in the foreregion of the foot),
is due to the repetitive compression
of the common
plantar digital nerve.
This nerve lies between the heads
of the metatarsal bones. Consequently,
the neuroma that develops is not a true
neuroma, but rather a manifestation
of chronic nerve compression.
The almost universal surgical approach
for the treatment of Morton’s is
to resect (cut out) the "neuroma"
through an incision on the top of your
foot. However, if the morton’s
neuroma is excised, the chances are
good that a true neuroma will develop. |
| How
does a TRUE neuroma develop from a cut
nerve? |
| When
a nerve is cut, the piece of nerve that
is beyond the cut point eventually dies,
however, its Schwann cells, the cells
that encircle the nerve fibres remain
for a much longer time. These Schwann
cells secrete a chemical messenger known
as nerve growth factor that tells the
cut end of nerve where to grow back.
So the cut end of nerve will send out
multiple sprouts in the direction of
the nerve growth factor, however, these
sprouts do not go out in an orderly
manner, instead they grow out in all
directions and eventually cluster and
form a knot of nerve fibres. This eventually
leads to the formation of a TRUE neuroma.
If it is in a place on
your foot where you put a lot of pressure,
it will become very painful. |
| Our
surgical treatment for a Morton’s
neuroma: |
| Our
treatment for a Morton’s neuroma
is to release the deep transverse intertarsal
ligament, this is the deep ligament
at the joint that the nerve passes beneath.
Intrinsic fibrosis or scarring is released,
and the epineurium is opened. |
|
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