The standard name of Morton's plantar headache should be inter plantar neuroma, also known as inter metatarsal neuroma, Morton neuralgia, localized interphalangeal neuritis, etc., which is a syndrome of pain and other symptoms caused by any common toe nerve stimulation or compression.Neuroma is not a real tumor, but it gets its name because it looks like a tumor after the nerve is compressed.
This disease is a non neoplastic, focal degenerative disease, usually involving the toe nerve, manifested as fibrosis and edema of the involved nerve, causing paroxysmal pain in the sole of the foot.This disease is caused by long-term recurrent nerve injury and ischemia caused by vascular and perivascular fibrosis.Different from traumatic neuroma, this disease is mainly manifested by some degenerative changes of nerve fibers, including the fibrosis of epineurium and perineurium, vitreous degeneration of perineural tissue and inner nerve vascular wall, and less axon and Schwann cells.The symptoms can be alleviated by changing the high-heeled shoes that do not match the size of the shoes or by injecting hormones and anesthetics, and the lesions can be removed if necessary.
Long term recurrent nerve injury and ischemia caused by vascular and perivascular fibrosis
common symptom
Local pain, aggravated when walking
Chinese name
Morton's plantar headache
pathogeny
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This disease is caused by long-term recurrent nerve injury and ischemia caused by vascular and perivascular fibrosis.
clinical manifestation
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The most common and earliest symptom of inter plantar neuroma is local pain, which worsens when walking. Early rest, taking off shoes and socks and massaging the affected parts can alleviate the symptoms.
differential diagnosis
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This disease should be differentiated from the following diseases: lumbar disc herniation, tarsal tunnel syndrome, peripheral neuritis, metatarsophalangeal synovitis, metatarsophalangeal joint lesions caused by rheumatoid arthritis, gout, trauma, metatarsal head necrosis, and adjacent synovial cysts, lipomas, tendon sheath cysts, etc.
treatment
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1. Non operative treatment
The symptoms can be alleviated by changing the high-heeled shoes that do not match the size of the shoes or by injecting hormones and anesthetics.Surgical treatment can be performed when non operative treatment fails.
2. Resection of inter plantar neuroma
Neuroma resection via dorsal foot incision: make a longitudinal incision in the metatarsal space along the dorsal foot where the neuroma is located, starting from the toe web and extending backward, about 3cm long.
3. Neurolysis
In recent years, due to the complication of neuroma at the severed end after amputation, nerve relaxation methods have been proposed, such as cutting off the transverse plantar ligament to release the trapped nerve.
