诊断

医生在检查期间会按压您的脚部,来感觉是否存在肿块或压痛点。您也可能会感觉到脚骨之间有“咔嚓”声。

影像学检查

在莫顿神经瘤的诊断中,有些影像学检查比其他检查更有用:

  • X 线检查。医生可能会安排您进行足部 X 线检查,以排除疼痛的其他原因,例如应力性骨折。
  • 超声波。这项技术利用声波生成内部结构的实时图像。超声波在揭示软组织异常(如神经瘤)方面效果尤佳。
  • 磁共振成像(MRI)。MRI 利用无线电波和强磁场,也能生成清晰的软组织图像。但这项检查价格昂贵,常用于检查无症状患者身上的神经瘤。

治疗

治疗方法基于您的症状的严重程度。医生可能会建议您先尝试采取保守的治疗方法。

治疗

穿为脚掌和脚趾留出足够空间的鞋。足弓支垫和脚垫(如跖痛症专用鞋垫)可以放在鞋内,有助于减轻对神经的压力。足弓支垫和脚垫无需处方即可购买,医生也可以为您开具定制、单独设计的鞋垫(按照您足部的精确轮廓模塑)。

外科手术及其他手术

如果保守疗法没有帮助,您的医生可能会建议:

  • 注射。对于某些患者,将类固醇注射到疼痛区域会有所帮助。
  • 解压术。在某些情况下,外科医生可通过切割附近的结构(例如将脚前部的一些骨骼绑在一起的韧带)来缓解神经压力。
  • 切除神经。如果其他治疗方法无法缓解疼痛,则可能需要通过外科手术切除神经。尽管手术通常会成功,但该手术可能导致受累脚趾永久麻木。

Surgery

If other treatments don't work, your healthcare professional may recommend surgery. Surgical removal of the damaged, enlarged portion of the nerve is called a neurectomy.

This is the most common procedure for treating Morton neuroma. The surgery is usually successful, but there may be permanent numbness in the affected toes.

Other procedures that haven't been studied extensively may be used. These include procedures that:

  • Disable the affected nerve without removing it.
  • Create more space for the nerve in the forefoot by cutting tissues that connect bones.

生活方式与家庭疗法

为了帮助缓解与莫顿神经瘤相关的疼痛,并让神经愈合,请考虑以下自我护理提示:

  • 服用抗炎药物。非处方非甾体类抗炎药,例如布洛芬(Advil、Motrin IB 等)和萘普生钠(Aleve),可以减轻肿胀并缓解疼痛。
  • 尝试冰敷按摩。定期冰敷按摩有助于减轻疼痛。冷冻盛满水的纸杯或塑料泡沫杯,然后在疼痛部位滚动冰块。
  • 换种鞋穿。避免穿高跟鞋或挤脚的鞋子。选择鞋头较宽、鞋底较深的鞋子。
  • 休息一下。几周内,减少慢跑、有氧运动或跳舞等会使脚受到强烈冲击的活动。

准备您的预约

针对您的足部疼痛,您可以先咨询家庭医生。家庭医生可能建议您去看专攻足部疾病的医生或外科医生。在就诊前,您可能需要列出以下问题的答案:

  • 您的症状从什么时候开始?
  • 您的症状是逐渐出现还是突然出现?
  • 您上班穿什么样的鞋?
  • 您是否参加体育运动?如果是,具体是什么类型?
  • 您经常服用什么药物和补充剂?

What you can do

Before your appointment, you may want to write a list of answers to the following questions:

  • When did your symptoms begin?
  • Did your symptoms begin gradually or suddenly?
  • What type of footwear do you wear for work and recreation?
  • Do you participate in sports? If so, what types in particular?
  • What medicines and supplements do you take regularly?

医生可能做些什么

医生可能会问下列问题:

  • 穿上某类鞋子会导致疼痛加重吗?
  • 哪些类型的活动会减轻或者加重疼痛?
  • 您身体的其他部位疼痛吗?
March 25, 2023
  1. Morton's neuroma. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/mortons-neuroma. Accessed March 16, 2021.
  2. Frontera WR, et al., eds. Morton's neuroma. In: Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed March 16, 2021.
  3. Lu VM, et al. Treating Morton's neuroma by injection, neurolysis, or neurectomy: A systematic review and meta-analysis of pain and satisfaction outcomes. Acta Neurochirurgica. 2021; doi:10.1007/s00701-020-04241-9.
  4. Ferri FF. Morton neuroma. In: Ferri's Clinical Advisor 2021. Elsevier; 2021. https://www.clinicalkey.com. Accessed March 16, 2021.
  5. Fields KB. Evaluation and diagnosis of common causes of forefoot pain in adults. https://www.uptodate.com/contents/search. Accessed March 16, 2021.
  6. Azar FM, et al. Neurogenic disorders. In: Campbell's Operative Orthopaedics. 14th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed March 16, 2021.
  7. Morrow ES. Allscripts EPSi. Mayo Clinic. March 22, 2021.

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