BTN News: In the glittering world of royalty, where every public appearance is scrutinized, it’s easy to forget that figures like Queen Letizia of Spain also contend with common health issues. Amid her demanding schedule, Queen Letizia was diagnosed in 2022 with a painful foot condition known as Morton’s neuroma. This diagnosis, which has since drawn significant media attention, serves as a reminder that even those in the highest echelons of society are not immune to everyday health challenges. Surprisingly, this condition is more prevalent than many might think, affecting between 10% and 20% of the population, with women, particularly those aged 25 to 50, being the most at risk.
Morton’s neuroma, often mistaken as a mere inconvenience, is a significant condition involving the inflammation of nerves located between the metatarsal bones in the foot, typically between the third and fourth toes. This inflammation can lead to sharp pain, tingling, and a disconcerting sensation that mimics stepping on something foreign inside the shoe. These symptoms can significantly hinder daily activities like walking or standing for prolonged periods, making the condition more than just a trivial issue.
According to Dr. Miguel Barrientos, a specialist in foot and ankle trauma at the Clínica Internacional, Morton’s neuroma has multiple causes. He explains that the condition is often the result of biomechanical and anatomical issues specific to each individual. These can include improper functioning of the hallux (commonly known as the big toe), shortened calf muscles, bunions, flat feet, high arches, foot deformities, or injuries related to sports or trauma. Furthermore, the use of inappropriate footwear is a significant contributing factor. Dr. Barrientos emphasizes that tight, narrow shoes, particularly high heels, greatly increase the risk of developing this painful foot condition. Additionally, physical activities that involve repetitive impact, such as running, dancing, or playing tennis, can exacerbate the problem.
Diagnosing Morton’s neuroma can be tricky, as its symptoms are often confused with other conditions. This can lead to delayed treatment, which may worsen the condition. Common symptoms include sharp pain or a burning sensation in the foot that can radiate towards the toes, tingling or numbness in the affected toes, and a feeling akin to having a pebble or wrinkled sock inside the shoe. These symptoms typically intensify when walking or wearing tight shoes, particularly high heels. As the condition progresses, the pain may become more severe, persisting even after removing shoes and massaging the foot.
The diagnosis of Morton’s neuroma is typically clinical, but additional imaging tests like ultrasound or MRI may be necessary to confirm the presence of the neuroma and rule out other potential causes of foot pain. Dr. Rodrigo Gallo, a trauma specialist at Clínica Ricardo Palma, notes that the diagnostic process often includes a detailed medical history, a physical examination using the Mulder test (a maneuver that replicates the pressure exerted by footwear to provoke the characteristic discomfort of Morton’s neuroma), and, if needed, imaging tests to confirm the diagnosis.
Treatment for Morton’s neuroma varies depending on the severity of the symptoms. In the early stages, a conservative approach is usually recommended. This might include switching to more appropriate footwear with roomy toe boxes and cushioned soles to reduce pressure on the affected nerve. Orthotic inserts can also be custom-made to help redistribute the weight across the foot, relieving pressure on the neuroma. Anti-inflammatory medications may be prescribed to reduce pain and inflammation, but these should always be taken under medical supervision. Corticosteroid injections into the affected area can also help to reduce inflammation and alleviate pain. Physical therapy, including specific exercises and treatments, can further help to reduce inflammation and improve foot mechanics.
For more severe cases where conservative treatment fails to provide relief, surgery might be considered. Surgical options include neurectomy, which involves the removal of the affected nerve, or newer techniques like cryogenic neuroablation and radiofrequency ablation, which use extreme cold or electrical currents, respectively, to destroy nerve tissue and prevent pain signals from reaching the brain.
Preventing Morton’s neuroma involves adopting healthy habits and being mindful of footwear choices. Dr. Gallo advises wearing comfortable shoes with proper support, avoiding narrow-toed shoes and high heels. Custom orthotic inserts can be beneficial in reducing pressure on the forefoot. Maintaining a healthy weight also helps in reducing foot pressure, and regular exercises that strengthen the muscles of the foot and leg can further help in prevention. For those involved in high-impact activities, using appropriate protective gear and techniques is crucial.
Untreated Morton’s neuroma can lead to nerve damage or chronic pain in the affected foot, highlighting the importance of seeking medical advice at the first sign of symptoms. Early diagnosis and treatment can make a significant difference in managing the condition and improving the quality of life for those affected.
