Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
A neuroma is growth (benign tumor) that arises in nerve cells. A Morton's neuroma is a swollen, inflamed nerve located between the
bones at the ball of the foot (usually either the second or the third
spacing from the base of the great toe). A Morton's neuroma is caused
by compression of the nerve of sensation between the ends of the
metatarsal bones at the base of the toes.
What are symptoms of a Morton's
neuroma?
A Morton's neuroma causes a "burning"
sharp pain on the bottom of the foot in the involved area. The pain of a Morton's neuroma can
radiate
to the nearby toes. The pain is usually increased by walking or when
the ball of the foot is squeezed together and decreased with
massaging. It may force a person to stop walking.
How is a Morton's neuroma diagnosed?
The diagnosis of a Morton's neuroma can usually be made by the doctor when the history of pain suggests it and the examination elicits the symptoms. The foot is usually tender when the involved area is compressed and symptoms of pain and sometimes tingling can be elicited when the sides of the foot are squeezed. Magnetic resonance imaging (MRI) or ultrasound testing can be used to confirm the diagnosis if necessary.
How is a Morton's neuroma treated?
Symptoms of a Morton's neuroma can completely resolve with simple treatments, such as resting the foot, better-fitting shoes, antiinflammation medications, and ice packs. More rapid relief of symptoms can follow a local cortisone injection. Symptoms can progressively worsen with time. For those with persistent symptoms, the swollen nerve tissue is removed with a surgical operation.
Foot pain may be caused by injuries (sprains, strains, bruises, and fractures), diseases (diabetes, Hansen disease, and gout), viruses, fungi, and bacteria (plantar warts and athlete's foot), or even ingrown toenails. Pain and tenderness may be accompanied by joint looseness, swelling, weakness, discoloration, and loss of function. Minor foot pain can usually be treated with rest, ice, compression, and elevation and OTC medications such as acetaminophen and ibuprofen. Severe pain should be treated by a medical professional.
An MRI (or magnetic resonance imaging) scan is a
radiology technique that uses magnetism, radio waves, and a computer
to produce images of body structures. The MRI scanner is a tube
surrounded by a giant circular magnet. The patient is placed on
a moveable bed that is inserted into the magnet. The magnet creates
a strong magnetic field that aligns the protons of hydrogen atoms,
which are then exposed to a beam of radio waves. This spins the
various protons of the body, and they produce a faint signal
that is detected by the receiver portion of the MRI scanner.
The receiver information is processed by a computer, and an image
is produced.
The image and resolution produced by MRI is quite detailed and can
detect tiny changes of structures within the body. For some procedures, contrast agents, such as gadolinium, are used to increase the accuracy of the images.
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