The article describes Morton’s neuroma, presents a clinic of the disease with a description of the nature of the pain syndrome and neurological symptoms. The measures for the prevention and conservative treatment of Morton’s neuroma are described, including the use of orthopedic insoles and other orthopedic aids.
Tunnel or compression syndromes / neuropathies are one of the most common groups of diseases of the peripheral nerves and constitute, according to different authors, from 25% to 40% of all diseases of the peripheral nervous system.
In the scientific literature there is information about two diseases of the foot, which are associated with the name of the American surgeon Thomas George Morton (1835-1903). The first is Morton’s foot, otherwise, the syndrome of insufficiency of the first metatarsal bone, in which the second toe of the foot is longer than the first, which is a factor predisposing to the formation of the hammer-like second toe. The second is Morton’s neuroma, a manifestation of tunnel syndrome in which the nerve that passes between the heads of the 3rd and 4th metatarsal bones suffers. This disease has many synonyms: metatarsalgiya Morton, plantar interdigital neuroma, interplusus neuroma, foot neuroma.
In 1876, Thomas Morton first described the syndrome observed in 12 patients with an “unusual and painful lesion of the 4th metatarsophalangeal joint”. In studying this pathology, Morton suggested that mechanical compression of the nerve with the heads of the metatarsal bones is the main mechanism for the development of the disease.
Compression neuropathies are currently believed to be a polyetiologic disease. In their formation play an important role as a genetic predisposition, and the impact of exogenous and endogenous factors. Among the many etiological factors that cause the development of tunnel neuropathies, it is necessary to highlight the main ones that play a major role in the formation of Morton’s neuroma. These include: transverse flatfoot, wearing close shoes (including shoes
with high heels and narrow nose), acute traumatic injuries and hematomas at the site of localization of nerve fibers, irregular gait with turning the foot inwards, obliterating diseases of the lower extremity vessels, overweight, increased load on the front foot, infectious and autoimmune diseases, changes in the structure of the nerve, lipomas of various types.