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Morton’s neuroma is a common condition that affects the third space between the toes. The condition is also referred to as interdigital neuroma. This painful foot condition is due to enlargement of the nerve of the foot.
There are a number of conditions that can be mistaken for neuroma. Read on to learn about the differential diagnosis of Morton’s neuroma.
A stress fracture may be mistaken for neuroma. This is actually a small crack in the bone that can develop from overuse or can also be from weakening of the bone by conditions such as osteoporosis. Symptoms of stress fractures are pain, swelling, tenderness on a specific spot, and continued pain at rest as the fracture damage progresses.
Tarsal tunnel syndrome occurs from abnormal pressure on a nerve in the foot. Usually, the symptoms are vague pain in the sole of the foot, burning, or tingling sensation. The pain gets worse with activities such as walking long distances or standing for long periods. It is occasionally mistaken for Morton’s neuroma because the pain and tingling may also occur on the toes.
Peripheral neuropathy, like Morton’s neuroma, is due to nerve problems. In neuropathy, the pain is described as tingling or burning. There can be extreme sensitivity to touch, lack of coordination, or muscle weakness. The pain may also spread upward to the legs.
A ganglion is also another differential diagnosis for neuroma. This is like a balloon that arises under the skin. Although often seen on the wrist, the cyst also frequently develops on the foot. In contrast to neuroma, a ganglion cyst may have a noticeable lump. If the cyst is touching a nerve, this causes burning or tingling sensations.
Arthritis of the feet may occasionally be mistaken for neuroma. Osteoarthritis is wear and tear arthritis, resulting to swelling, inflammation, and pain. Some people with rheumatoid arthritis may also have pain in the heels because of plantar fasctiis. The symptoms may also appear in several joints on both feet. The toes may also begin to stiffen. To differentiate arthritis, range of motion tests or x-rays may be done.
Another very common condition that leads to foot pain is bursitis. Again, this may also be mistaken for Morton’s neuroma. A bursitis is inflammation of the bursal sac, which contains fluid to lubricate and reduce friction between two surfaces in the body. With bursitis, the top of the toes can be very tender, red, and slightly swollen. Most of the time, pain is relieved when the shoes are removed.
The various differential diagnoses of neuroma must be carefully considered to exclude these other common conditions of the feet. When a definitive diagnosis of Morton’s neuroma is made, conservative management can be tried from three months to one year.