Morton's Neuroma - Everything You Need To Know - Dr. Nabil Ebraheim
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- เผยแพร่เมื่อ 26 ก.ค. 2011
- Dr. Ebraheim’s educational animated video describes the condition known as Morton's Neuroma.
Morton's Neuroma is a chronic irritation of the interdigital nerve, usually the one innervating the third web space. The irritation causes entrapment, compression and perineural fibrosis rather than a neuroma. The involved nerve is compressed or pinched as it runs between the third and fourth metatarsal heads under the deep transverse metatarsal ligament on the plantar aspect of the foot. Focal swelling of the nerve occurs secondary to the perineural and intraneural fibrosis. It usually affects middle aged females.
The patient complains of pain in the third web space between the third and fourth metatarsal, radiating to the third and fourth toes. Pain is worse with walking, weight bearing and with wearing narrow toed shoes. The pain is better with rest, elevation, removal of the shoes and massaging of the foot. The pain does not occur at night. The patient may complain of paresthesia at the bottom of the web space.
Examination:
•Squeezing the metatarsals together can cause shooting pain that will go into the third and fourth toes.
•The neuroma may be palpable.
•Tinels’ sign may be positive.
•Mulder’s sign: compression of the forefoot with one hand and simultaneously applying upward pressure on the affected web space with the thumb will produce pain and palpable click. The Mulder's sign or click does not occur in all cases.
Ultrasound may be helpful in diagnosis and MRI is rarely used.
The common digital nerve block may be confirmatory for diagnosis.
Differential diagnosis:
•MTP synovitis: patient will not have relief from the digital nerve block.
•Stress fracture
•Metatarsalgia
•Arthritis
•Lumbar disc herniation: L5 nerve root distribution.
Treatment
Nonoperative
•Wide shoe box
•Anti-inflammatory medication
•Injection of steroids
Surgery:
•In cases of failure of nonoperative treatment.
•Can do dorsal or plantar approach. Dorsal is more popular.
•Neurectomy or excision of the neuroma with release of the deep transverse intermetatarsal ligament. Resect the nerve as far proximal as possible to prevent recurrence of the neuroma and the symptoms.
•Complications of surgery: painful plantar scar and stump neuroma when resection of the nerve is not proximal enough.
![11 BEST Mortons Neuroma Massage, Exercise & Stretch Treatments [WOW!]](http://i.ytimg.com/vi/XsQhGOzPggc/mqdefault.jpg)
![11 BEST Mortons Neuroma Massage, Exercise & Stretch Treatments [WOW!]](/img/tr.png)
I found the quickest and easiest fix for Morton’s Neuroma was to add a folded up piece of foam (from a spare insole) between the two toes (second and third for me), and more foam the better. Now I can run 15 miles + pain free. Hope this helps
Thank you!
So very kind...thank you!👣
Thank you
After lossing a few handmade foam spacers, kitchen towel is also very affective at preventing any pain, folded up 6 time and placed in between the said toes 🤙🏻
Thank you Dr. Ebraheim. Excellent animation and explanation. Please continue to upload educational videos!
We treat many women suffering from Morton's neuroma at my Michigan podiatric practice- thank you for spreading the word. Ladies- check your feet daily to make sure your feet aren't damaged!
Love all your videos, Dr. Nabil Ebraheim. Thank you so much for sharing. I'm learning so much watching your videos.
Very informative video. Morton's neuroma pain is really a problem and around half of patients who undergo surgery for neuroma regret it. At times, pain can be worse than the original neuroma.
Thank you for your easy and kind explanation about the Morton's neuroma!
Very helpfully explained and described to the lay person. Thank you Dr.
I was told I had Morton's Neuroma today, didn't really know what it was BUT this video explained everything!!!!! Thank you for making this video!
I went to the Dr. I was in so much pain. I had an ultrasound. I paid attention to what she was doing. My ultrasound tech was wonderful. She explained everything that I asked. This video is SO RIGHT ON. EVERYTHING he talks about..is everything that happened to me., word to word/step by step. Yes i was diagnosed with MORTON'S NEUROMA. Thank you so much for this video.
Did you have surgery?
How were you treated ? This what we need to know because the pain is awful
Thank you doctor, for your simple and concise explanation.
I was just thinking that I need to brush up on this subject and your video appeared like magic. Fantastic video as always.
Excellent demonstration
Thank you Nabulsi, it’s very good to know !
Thank you very much for this video.
Excellent presentation!
@drmam17 start with an xray then do mri or bone scan
location of the pain and clinical picture of tingling
Awesome video. Thanks.
Thank you! I have all the symptoms including the click of the toe. The numbness, pain and burning sensation that I feel is horrible. I feel like I'm standing on marbles. Once the pain started it's impossible for me to walk so I start limping. The pads that my Podiatrist made for my shoes are not helping at all. Thanks at least now I know what my problem is.
Thank you. Very helpful
I was diagnosed with 5 neuroma's. 3 in my right foot and 2 in my left foot. 2 out of the 3, in my right foot, are located between the 2nd & 3rd metatarsal, and the 3rd and 4th metatarsal. The 3rd one is close to the heel. The 2 in the left foot are located between the 2nd & 3rd metatarsal, and the 3rd and 4th metatarsal. I suffered with constant burning pain for 5 years! I even went out and bought myself a wheelchair so that I could go out into the community and not have to stand. I finally found a podiatrist who treats them by injecting a solution of Vitamin B12 and alcohol. I just had my 4th round of injections yesterday, and the pain in my feet is about 90% better. I suffered needlessly for 5 years so I want to share this information so other people don't have to go through what I went through
I am trying to find a podiatrist that does this.... what doctor did you go to? was it ultrasound guided?
Hi Patricia, I'm sorry, I just saw your post. It didn't go into my regular gmail inbox. The doctor I went to is Dr. Ira Shandles, in Tampa, FL. And, yes, it was ultrasound guided.
Did these injections also kill the nerves(along with the Neuroma)? Or can you still feel your toes? My dovtor says it will also kill the nerves...
David G Firstly, it feels like I’m writing myself here lol
Strangely, I have occasionally felt this clicking sensation wearing boots, but never understood what was causing it. I got another pair of boots, different style Dr. Martens, and same thing!! I am running every second day and have never felt that sensation. I did a test comparing the boots to my running shoes by standing on the front part of the shoes and instantly noticed the clicking with the boots but not the running shoes. Unfortunately, I didn’t read about this until after I pushed it and now it’s been hurting for over a week. I’m waiting for it to go away by avoiding the boots, but maybe it won’t.. I’ll have to read some more. Just heard about the b12 correlation, interesting. Some 40% of US is deficient
good one, thank you...
When I was younger (I'm in my 60s), I could find plenty of shoes that were flat, which was essential because I had a slim but not narrow foot. Narrows were a bit tight and regular fit me like boxes. If I wore a bigger (regular width) shoe with a heel, my foot would have been shoved forward, creating more problem. Shoes I could find back then (whether a tad too narrow or a tad too big), though shaped badly, at least didn't put extra pressure on my foot because they were flat. Unfortunately, after being bed bound for many years, just getting up and moving again caused overuse injuries in my hypermobile feet. When I started walking again, all I could find were these new flat shoes that weren't actually zero drop. (And I couldn't wear something like Chucks because they didn't work for the shape of my foot.) Today's (2020) zero drop shoes (what's out now for someone looking for a flat shoe) tend to be minimalist shoes and have little protection for the injured foot. It's ridiculous what we've been forced into by shoemakers. I'm so ticked having done the best I could in life to protect my feet only to ruin them when I was no longer bedridden because I couldn't find flat shoes.The only minimalist shoes that were out when I started walking again were Five finger vibrams and they don't fit for the same reason Chuck's didn't -- my pinkie toe placement. (Birkenstocks also never fit my feet.) So now I'm feeling better, less crippled by illness, but more crippled by my feet.
People: wear flat shoes with a foot shaped toe box and if your feet look like the shape of common dress shoes, use devices to realign your toes before you end up in terrible shape unable to walk without pain.
So helpful!!
helpful. thank you
Thank you!
This Doctor’s Explanation Is “Right On The Mark”.....I know, because I have a Morton.
Decided today 10-29-2020 to have the “Outpatient surgery” to remove this bad boy. I’ve been in pain way to long.
Pls share with us ur experience after surgery .... plss
How do you feel after surgery?
excellent
Thank you 🙏
Thanks doctor
thanks Dr!
Good, thanks
Thanks
Now that you know what it is here is what I do to help make it bearable to walk because it gets so bad at times its like stepping down on a 12 common nail every time I plant my foot on the ground. take a foam earplug (wider the better) and place it between your 2nd & 3rt toe to space them apart and put a sock over your foot as you normally would and use socks that aren't to small and compress your foot and then put on your footwear (wide toe box if you can) and see the difference it makes! I was at work and it was unbearable and I did this and cant even put into words what a relief it was...give it a try you have nothing to loose and everything to gain! GOOD LUCK!
Thank you, I have just been diagnosed with this and your video is very helpful indeed. Could you advise me if there are advantages to cryosurgery please Dr Nabil, many thanks to you.
Hello, Dr. Ebraheim. I wanted to share with you something I discovered and worked remarkably well for me, that you might be able to use for your patients. A soft cast, silicone, or rubber (in my particular case, I had a... erm... ring of this type in my nightstand, that I placed over my middle toe). It keeps the metatarsals from grinding the nerve between them, it's easy to use, inexpensive, and for me, anyway, very effective, as it stays on day and night.
I went to Dr yesterday - I am having surgery soon for this problem. Mine is 2nd 3rd toe left foot. I will also be having nerve removal - knuckle removal - shortening of metatarsal bone. Thanks so much for helping me understand it a little more -
i recently had cryo surgery on my planta faciitis which seemed to work but i think i have this from compensating for that injury by walking on the front of my foot, would this injury over time amend itself or would you need something doing to it, i find that its more of a numb pain but in the exact area where the video shows, your videos are so helpful thank you
Meaningful.
I have had a fusion of my big toe. Since then, I have extreme pain in the ball of my foot. I have been told that I have a neuroma. I have had 4 foot surgies and don't want to have another one if there is no neuroma. Is an ultrasound the best diagnostic to rule it out or confirm the diagnosis?
Awwww this is what I have almost 5 years, those 2 fingers are numb, Thank you 👍🙋♀️
I think you mean toes not fingers.
@@karenimran3349 yes 😂👍
I had a talus ankle fracture some 18 years ago.... it still hurts in the morning when i wake up walking, and after long standing without walk like when invited to a reception, it also hurts after using a ladder. when i do sports it does not hurt when cycling but cannot run on it. Do you suggest steroidal infiltration?
I was told that I have this but I do not experience pain at the bottom or ball of my foot, just on top and between the 3rd-4 toes. I have suffered a herinated disc but haven't had pain in years. I walk 5-6 hours daily as a letter carrier, which shoe support is best?
Hi great video. What kind of shows do you recommend. I got my MN in 20191 and when I started running in 2022 with 10mm drop shoes the problem was back. Since then I’ve bought a pair of Vivo bare foot shoes but on my last walk with them I was in so much pain I had to take them of. In 2019 it was so bad I couldn’t ware shoes for a year. Is it maybe Altra running shoes. Wide toe box zero drop with couching?
Nice
When one get this Neuroma, won’t it go away normally with ample rest? I got mine stepping on a hard object barefoot and aggravated it with a couple of days walking with snow boots on in a tour.
I would like to know what happens to me because I have a pronounced arch since baby, and all my life I have worn slippers and has been living in Canada for 6 months and here walks barefoot at home, apart from the pandemic because zero heels pure tennis in the street, that thing of not wearing shoes may have affected me? My little finger in the middle is pretty swollen and I'm in a lot of pain, I started yesterday morning and last night I couldn't sleep
I thought i had it, i mean i had all the symptons but i went to a chyropractor and he said that there were nerves on top of eachother and then he put them into their place. BTW my foot was hurting for a whole week i was literally limping. Just in two to days i was able to walk normally.
I've been having pain underneath the 3rd & 4th toes for the past 4 days now. Feels like I have a rock in my sock or the sock bunched up under those toes. The pain is felt when I stand up or walk; however, when I walk i feel as if some tendon/ligament between the toes is getting stretched to its limit. It starts between the 3rd & 4th toes and shoots to the top of them. I googled and it seemed is was what I have, so I youtube and found your video. After watching, seems this isnt what I have. So..?
Yo también tengo ese dolor
@rumit99 thanks
hi dr nabil i have a question .
how to differentiate between morton's neuroma and stress fracture in runner women came with same complain for both ?
clinically
thank u dr
I suffered with Morton's Neuroma in both feet for many years, my friend had hers removed 20 years ago an never regret it. I had my right foot operated on in May of this year 2015. I still feel their is something wrong it still aches and burns .... I'm now having my left foot done this month September, I hope I don't regret it !! They hurt's so bad I'll try anything !! I'm 66 yrs. old and still working,...
Police
nice
Think I got this foot is sore in the same place and it burns tingles feels numb sometimes to ,sometimes it feels cold .
51 year old man, I have been suffering for three months, and gonna lose my job very soon. Cortisone jab two weeks ago only helped a little.
It feels like it’s going away, then it comes back again. 😕
Cushions between the middle toes! And get ultrasonic therapy from your physiotherapist with taping!
Cortisone is just a temporary thing!
Doctor, everything that you talked about in the video os what I have, I tried to tell my parents about it and they say that I am faking it what should I tell them
Go to a doctor...
You can heal it yourself! Put spatial cushions between your toes and wear wide shoes with a great Arch like Birkenstocks. No sneakers! Be diligent where those shoes and cushion spacers all day everyday. Ice the top of your foot regularly. Remember this is just a pinched nerve because it is inflamed from being squished! You want to reduce the swelling of the nerve by giving it space and cooling it off.
Hello,
When i try to flex my toes up while standing i feel like an electric painful shock between the 2nd and 3rd toes
But when i walk i dont feel any pain at all
Is it morton’s neuroma or something else??
star DIY I have the same symptoms, but it is.
I have just had an operation to remove a neuroma from my right foot I have another in the same foot and 2 more in my left foot. This is my eighth day and stitches are still in I don't believe that this is caused from wearing tight shoes. I am known for not wearing shoes around the house and have stubbed my toes on many occasions I think this started it all. My sister has the same condition and she also has very slim feet with very little padding on them. Is this hereditary
so how is your foot doing now
This sounds exactly like what I'm experiencing in my left foot. Right in between the 3rd and 4th toes I have a sharp pain underneath and it almost feels like a numbing sensation, or like ThisNamesNowTaken said below, like a rock in my sock. I'm also experiencing hyper-sensitivity on the top of the foot, like the nerves are right near the surface and it sometimes hurts to touch it. I've always had narrow feet with high arches and I think my arches are starting to fall as well.
My feet is the same, very high arch, and now this is happen, I'm so sad I would like to know what happens to me because I have an arch pronounced since baby, and all my life I have worn slippers and has been living in Canada for 6 months and here walks barefoot at home, apart from the pandemic because zero heels pure tennis in the street, that thing of not wearing shoes may have affected me? My little finger in the middle is pretty swollen and I'm in a lot of pain, I started yesterday morning and last night I couldn't sleep
What do you do to relieve the pain?
Has anyone had surgery for Morton’s Neuroma?
I have this painful condition. This was caused through injury. I’ve just had a steroid injection the second in eight weeks. Next step is surgery.
I have lived with it for years, can't wait for the Med Beds!!!!
I had 2 MNs and a bone spur removed during surgery a little over 3 weeks ago. I am experiencing tightness across the top of my foot periodically. Is this normal?
how is your foot now
It has been almost a year since my surgery. I still have numbness across both toes,
and the scar tissue on the ball of my foot is uncomfortable. That being said - it is NOTHING like the pain from the MNs!!! I have a hard time walking barefoot on hard flooring. Good luck with yours!
You had your nerves removed? Wouldn't that cause numbness and paralysis anyhow? I was actually told ultrasonic therapy reduces the swelling then cushions between my toes all day although it's uncomfortable will create space and allow the swelling to decrease in the nerve. Did you try anything before you did the surgery?
wore high heels with gap at the end of the shoe for 10 hours yesterday, today my foot fucking hills my 2 toes on each foot is numb and the ball on both is numb, not really a burning sensation but it is tingly, i am so worried i have this i am only 18 and probably about my 5th time wearing heels
What did it end up being for you?
Just had a Dr tell me ultrasound was not a good way to find neuromas.
OMG! Its the 'Toe-minator'!
LOLOL
did you know that Morton's neuroma was not first described by Dr. Thomas Morton? it was first described by Filippo Civinini.
Not uncommon among eponyms.
@@wholeNwon Civinini Neuroma? :)
@@chutzestuck Westphal und Strumpell disease.
ONE OF THE OPTIONS IN TREATING MORTON'S NEUROMA IS ABLATION WITH RADIOFREQUENCY WHICH GIVES A GOOD PERCETAGE OF SAISFACTORY RESULTS ( OVER 80%)
in severe pain. Cd you please tell me where I can find Raf procedure near San diego. goodwin. 760 5336709
Do you know where you can get this done or what type of doctor does this?
I just got diagnosed today and got shots in my foot. I'm 26 and have this in two toes in both my feet. I have never warn heals. I always ware boots or go bare foot at home. My doctor believes it's caused by my flat feet.
LVAngelradio Does it hurt?
I have explained the same. The doctor referred me to cortisone injection practice.
Mins a big one about 1.3cm in middle of big toe n second toe. I have not seen anyone else with one in this spot -_-
going on 6th week,a few scripts and injections no real relief yet.
Man I've had pain for two weeks with this .... any tips
I try to explain to a pt that he has gout and not Morton's neuroma.
Matatersalgia
Inner ankles wound ✍️
excellent !!! my doctor told me an m.r.i. must be done which cost over 300€ and now you just taught me that an ultrasound would work just as well which cost almost nothing !!! f#*k !!! should i do something to get my money back from that doctor ?
Doctor please Hindi mein
👍👍👍
E atât de dureros
Vreau să tratez
FUCK I MUST BE A MIDDLE AGED WOMAN
Would stem cells help?
Naturally it's a squashed and inflamed nerve. If you can unsquash it by creating spatial cushions between your toes it will alleviate the swelling of the nerve! Then naturally the nerve should stop sending pain signals as it's not being pinched anymore.
@@rachelkruitbosch3156 before ur response I went to Colombia for stem cells and didn't work. Then I did surgery to cut tendon only and it helped to some degree
Relax my ulcers ⏰👇🏾🛌🗣️🚪📺✍️
طعمية
Can a man have this? This sounds like my problem.