Morton’s neuroma

Morton’s neuroma

A type of perineural fibrosis described by Morton in 1876; it is not a true neuroma.
 
Clinical findings
Sharp, burning pain, commonly between the 3rd and 4th metatarsal heads, which is worse with direct pressure and better with rest.
 
Management
Conservative: metatarsal pads in the insole, loose footwear; tight high heels, ski boots, bike shoes are contraindicated; nerve blocks with a local anaesthetic and steroids. Surgery is recommended if conservative measures fail; if symptoms are limited to one web space, surgical outcome is excellent in up to 90%.
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