Morton's syndrome
Nov 25, 2024
Morton's syndrome is a chronic neuropathic pain caused by the thickening or irritation of the common digital plantar nerve, typically occurring in the area between the third and fourth toes. The condition usually develops beneath the deep transverse metatarsal ligament, where the nerve is subjected to repeated pressure. This leads to thickening of the epineural and perineural (nerve-surrounding) tissues and inflammation in the surrounding structures. The condition is triggered by prolonged pressure or irritation, resulting in chronic pain and discomfort.
### Causes:
1. **Footwear**: Narrow, rigid-soled, high-heeled shoes compress the forefoot, increasing the risk of Morton's syndrome.
2. **Biomechanical abnormalities**: Conditions such as flat feet or excessive pronation elevate pressure on the affected area.
3. **Chronic inflammation**: Repetitive stress induces inflammatory responses in the nerve's vicinity.
### Symptoms:
- Burning or sharp pain in the forefoot, radiating to the toes.
- Numbness or tingling in the affected toes.
- Sensation of having a pebble or fold in the shoe.
### Treatment Options:
1. **Conservative Therapy**:
- Wearing wide, comfortable footwear.
- Physical therapy focused on strengthening and mobilizing the foot muscles.
2. **Injections**: Corticosteroid or alcohol injections to reduce nerve inflammation and pain.
3. **Surgical Treatment**: If conservative methods fail, surgical removal of the nerve (neurectomy) might be necessary, although it may result in persistent numbness.
A 2018 meta-analysis published in the *Journal of Foot and Ankle Research* highlights that non-surgical treatments significantly alleviate pain for most patients.
### Prevention and Recommendations:
- Barefoot shoes, which do not compress the forefoot and allow for natural foot function, can help prevent or mitigate Morton's syndrome.
- Strengthening and mobilizing foot muscles is equally crucial to maintaining foot health.
Morton's syndrome not only causes pain but also impacts overall foot biomechanics. Affected individuals often alter their gait to avoid pain, increasing stress on the foot and knee joints. Studies indicate that approximately 8% of the adult population experiences Morton's syndrome. Its prevalence is influenced by gender, age, and footwear habits. Women are 4-6 times more likely to develop the condition due to their frequent use of narrow, high-heeled shoes. The syndrome is most common among middle-aged adults, especially those with existing foot deformities (e.g., hammer toes, flat feet), with peak incidence between 40 and 60 years.
### Causes:
1. **Footwear**: Narrow, rigid-soled, high-heeled shoes compress the forefoot, increasing the risk of Morton's syndrome.
2. **Biomechanical abnormalities**: Conditions such as flat feet or excessive pronation elevate pressure on the affected area.
3. **Chronic inflammation**: Repetitive stress induces inflammatory responses in the nerve's vicinity.
### Symptoms:
- Burning or sharp pain in the forefoot, radiating to the toes.
- Numbness or tingling in the affected toes.
- Sensation of having a pebble or fold in the shoe.
### Treatment Options:
1. **Conservative Therapy**:
- Wearing wide, comfortable footwear.
- Physical therapy focused on strengthening and mobilizing the foot muscles.
2. **Injections**: Corticosteroid or alcohol injections to reduce nerve inflammation and pain.
3. **Surgical Treatment**: If conservative methods fail, surgical removal of the nerve (neurectomy) might be necessary, although it may result in persistent numbness.
A 2018 meta-analysis published in the *Journal of Foot and Ankle Research* highlights that non-surgical treatments significantly alleviate pain for most patients.
### Prevention and Recommendations:
- Barefoot shoes, which do not compress the forefoot and allow for natural foot function, can help prevent or mitigate Morton's syndrome.
- Strengthening and mobilizing foot muscles is equally crucial to maintaining foot health.
Morton's syndrome not only causes pain but also impacts overall foot biomechanics. Affected individuals often alter their gait to avoid pain, increasing stress on the foot and knee joints. Studies indicate that approximately 8% of the adult population experiences Morton's syndrome. Its prevalence is influenced by gender, age, and footwear habits. Women are 4-6 times more likely to develop the condition due to their frequent use of narrow, high-heeled shoes. The syndrome is most common among middle-aged adults, especially those with existing foot deformities (e.g., hammer toes, flat feet), with peak incidence between 40 and 60 years.
