Morton’s Neuroma and High Heeled Shoes
People who wear tight, narrow, high heeled shoes for fashion or for their main occupation are at a much higher risk of contracting a condition known as Morton’s Neuroma. This is a painful condition that affects the ball of your foot and can cause a sharp, burning pain. It results in the thickening or enlargement of the toe nerve and unfortunately, if not treated, in come cases it can develop into the tumor of the nerve.
Morton‘s Neuroma will also cause pain when walking. It usually affects the nerve between the base of the third and fourth toes (third web space). The size of the nerve in this area is bigger than other web spaces, making it easier for it to become irritated. Furthermore, people who wear tight, narrow, high heels or those with flat feet are more prone to having this nerve compressed.
This nerve function is a sensation response. When compressed or squeezed the patient will feel a darting pain, similar to having an electric shock. They will also be reluctant to have the area touched, particularly in the ball of their foot. Other symptoms include a tingling or numbness in their toes or a burning sensation in the ball of their foot that may radiate into their toes. During examination, when their toe is held and pressure is exerted on the tip, or when the area between the base of the third and fourth toes is tapped, the patient will feel a darting pain to both toes; consequently, they are keen for the doctor to take their hand away and not to touch the inflamed area. Patients have also reported that when walking for long periods of time the pain will escalate to the point that they will be in too much discomfort to continue.
After administering an x ray to see the shape of the bones in the patients’ foot, there is also a need to perform an MRI (Magnetic Resonance Imaging) scan in order to observe the inflamed and swollen nerve. MRI is a type of scan that uses magnetic fields and radio waves to produce detailed images of the inflamed area and can also show the nerve as a 3D image. This can confirm whether the patient conclusively has the condition.
Treatment depends on the severity of the symptoms. An initial measure can be for a patient to change their shoes to a pair that are more supportive, however, perhaps not as aesthetically pleasing. Another approach is to take medicine, usually through an injection of anti-inflammatory steroids into the the affected area. However, if the symptom persist for a long time, these conservative treatments can be less and less effective and therefore a doctor may recommend surgery as the best option. In this relatively minor surgical procedure the surgeon will remove the permanently ruined nerve that cannot be recovered as it could potentially develop into a tumor.
The surgery is often done on the top surface of the feet rather than on the sole side, making it easier to clean and dress the wound. During the operation, the patient’s sensation will be controlled by either a spinal anesthesia or general anesthesia. The procedure itself will usually take around 20 to 30 minutes. Following this, the patient will be required to take a day’s rest before they can resume walking on the heel of their foot again. The wound is stitched by a soluble thread, which should remain in place without being removed. Furthermore, the effected area also needs to be kept dry for 7 to10 days, therefore it is advisable for the patient to apply a waterproof plaster to the wound.
After a successful surgery, the patient should not feel any further pain in the affected area. As the nerve has been removed, they will also have no sensation of the skin on the third and fourth toes. As time passes, sensation will return to the the skin around this area from the nerve of the nearby toes.
In conclusion, it is an individual’s choice whether to risk looking pretty in high-heeled shoes at the expense of a potential need for surgery. Of course, a doctor can offer medical guidance but essentially it is an individual’s personal preference.