How to Relieve Perineural Fibrosis or Morton’s Neuroma

injection névrômePerineural fibrosis is a rather scary term that actually represents a fairly common condition. When fibrous and fatty tissue surrounding a nerve experiences repeated trauma causing chronic swelling and scarring, it changes and hardens. When this irritation affects the nerve of the bones of the forefoot (metatarsals) associated with the third and fourth toes, it is called Morton’s neuroma.

Cyclists and skiers can sometimes suffer the painful consequences of this neuroma. Clip-on shoes for bicycles and ski boots that are sometimes too tight are conducive to its development. Indeed, the shape of the shoe, combined with the repeated pressure under the forefoot, compress the nerve in the metatarsal canal. In some athletes, it’s possible to develop several neuromas on the same foot or on both feet. Once this fibrosis has set in, simply standing still for long periods of time will be enough to trigger the pain.

Diagnosing Morton’s Neuroma

First of all, to find out if this is your case, you may describe your pain on the bottom of your foot as a series of electrical shocks felt between the toes and going to the tips of the toes. The most common way to explain this permanent sensation is that it feels like walking on a ball. A loss of feeling between the affected toes is also reported in many cases.

If you believe your nerves are damaged, it is advisable to make an appointment with your podiatrist as soon as possible, as over-the-counter pain relievers, compresses, ice and massage will not help in the long run.

By performing a palpatory examination, your podiatrist will attempt to reproduce the movements that trigger your pain under the foot in order to identify the cause and suggest appropriate treatments. Further tests, such as an ultrasound and x-rays, may be ordered to better visualize the extent of the swelling and to rule out other potential pathologies, respectively.

Treating Morton’s Neuroma

The most important point to consider before any treatment is the adaptation of your shoes, since the number one cause of the problem stems, more often than not, from shoes that are too tight. It is, therefore, recommended to choose shoes with wider toes and to avoid the steep slopes of high heels. A simple trick to determine if the width of your shoes is right for you is to take out the insole and place your foot flat on it. If your forefoot sticks out to the side, your shoes are too tight.

If you love high heels, or if they are better suited to your professional duties, know that the goal is to temporarily reduce the pressure applied to the forefoot and toes. Platforms or heels of less than two inches can be a good alternative, just long enough to relieve some of the pressure and symptoms so that your podiatrist can work with you. There are also metatarsal pads, commonly called French insoles, on the market at reasonable prices.

Of course, these indications are not the only treatments in the case of more complex neuromas or if the cause is due to deficient biomechanics, as for example, in the case of hollow or flat feet. Orthopedic inserts adjusted to your morphology will be of great help to stabilize your feet and reduce the excessive movements responsible for the pressure you feel.

In addition, before deciding on your last option, which tends to be the surgery to remove the neuroma, cortisone or sclerosing alcohol injections will be offered. Although a needle in the foot can be unpleasant, the injection technique will probably not cause you any more discomfort than a blood test.

In conclusion, your podiatrist will provide you with some foot muscle strengthening exercises to do at home to prevent the injury from worsening or returning each time you play your favorite sport. It’s also imperative that you wear shoes that are the right width and size.

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