One day you walk into your chiropractor’s office for regular maintenance and you incidentally ask, “Doc, might you also help me with a pain on the bottom of my foot?” You turn the sole of your foot upward to show him and press the edge of your thumb into the sore spot between the base of the toes in the fleshy roundness of the ball of your foot. He replies, “Morton’s Neuroma; they haven’t had much success with that. . .” Quite suddenly, you feel yourself age. You heard a diagnosis of something that quite possibly will pain you for years to come: the end of life looms like Scrooge’s Ghost of Christmas Future.
Thomas G. Morton, American Surgeon 1835-1903, with many other accomplishments to his credit, including performing in 1886 the first appendectomy with his patient surviving, founding the Philadelphia Orthopedic Hospital, and, the Infirmary for Nervous Diseases, is most known for his work on metatarsal pain first published in 1876.¹
Morton’s neuroma is a swelling of the nerves running between the metatarsals, the bones which at one end butt up against those creating the ankle and foot arch and at the other the phalangeal bones of the toes. The shafts of the metatarsals are long and fairly slender, but at both ends the metatarsal curve outwardly forming wide joint surfaces.² One of the common causes of Morton’s neuroma is compression across the width of the foot (for example, from too narrow shoes), so that metatarsal heads squeeze the nerve running between them producing nerve swelling, inflammation and pain.
Exact causes of Morton’s neuromas are not known, but suggested causes in addition to compression include a high arched foot (more pressure on the metatarsal/phalangeal joints), rolling the foot inward when walking (known as overpronation), and excessive upward bending of the toes or kneeling with the toes in dorsiflexion (underside of toes on floor or ground). Two other possible causes include swollen bursae (cushioning pads) or strained deep ligaments that lace and support the metatarsals pressing on the nerve.³
The most common location of Morton’s neuromas is between the 3rd and 4th metatarsal; between the 2nd and 3rd is next most common and between the 1st and 2nd, and 4th and 5th much more rare. Morton’s neuromas most commonly develop in women between the ages of 30-50, and having one in one foot yields a 15% chance of having another on the other foot.³
Common treatments of Morton’s neuroma includes ESPECIALLY eliminating any possible causes of excessive compression from either too narrow shoes or uncushioned or improperly supported high arches. Other common treatments include massage, ice packs or “cryo-therapeutic” salves, pads for the balls of the feet, athletic taping, different exercise techniques or styles, and of course, though less desirable, surgical or chemical impedance of the nerve.³
But here we are, talking about Morton’s neuroma in a Mind/Body article almost 150 years after Dr. Morton. A Mind/Body philosophy assumes that all things that transpire in the physical body are affiliated with patterns of thought, feeling, or “being-ness”, and vice-versa, that our thoughts, feelings and being-ness manifest in the physical body. What connections might exist between the possible mental, emotional or consciousness influences and a Morton’s neuroma?
Consider Foot Reflexology: a “reflexology map” of the bottom of the feet displays correlations between areas on the foot’s sole with organ, glandular and bony structures of the body.³ (Similar correlations are seen on an iridology map of the eye.) These are empirical maps developed over time based on observation. Explanations about how it works varies from pressure on peripheral nerves inducing relaxation to chemical endorphins being released to “zone” therapy similar to acupuncture.⁴
One foot reflexology map shows the areas where Morton’s neuromas are most commonly found relate to “zone 11 – the trapezium”; “zone 14 – the lungs and bronchii” and “zone 8 – the eyes.” The areas where Morton’s neuromas are less commonly found correspond on the reflexology map with “zone 12 – the thyroid” and “zone C – the thymus”.³ Interestingly, two different postings on a blogging site of another topic altogether mention Morton’s neuroma coexisting with rheumatoid arthritis (which can be linked with skeletal deformations as in the trapezium), glaucoma (the eyes), and lung nodules.⁵
Aromatherapy might be considered another empirical Mind/Body approach although scientific studies may be available more recently. Here again we find some interesting connections. An aromatherapist’s online recipe for an essential oil blend for the topical treatment of Morton’s neuroma included 35% Helichyrsum, 25% Rosemary, 20% Basil and 20% Lavender.⁶ Looking up the historical uses or applications of the individual oils, one can’t help but notice the connections to the Foot Reflexology map.
Helichrysum: used for asthma, bronchitis, burns and skin healing; Rosemary: used for skin, fortifying the nervous system and in ancient religious ceremonies; Basil: used to clear the sinuses, soothe bronchii, and relieve rheumatic pain; Lavender: used as an antiseptic, analgesic, and calming tonic.⁷
While foot reflexology and aromatherapy may not yield a Mind/Body connection either, they remind us that symptoms like Morton’s neuroma don’t usually exist independently nor manifest out of thin air. As the chiropractor suggests, a solution may not be easily found, but if we extend the amplitude of our search and not “buy into” a difficult diagnosis, we may use the opportunity to learn about our Mind/Body self and appreciate its intricacies.
As a naturopathic physician, the common link that jumps out at me intuitively is secretory IgA. Levels of this immunoglobulin are very influenced by diet and stress. Inflammation, stress and immune function are related. I’d investigate a gluten free, reduced stress lifestyle.
Katy Nelson, ND, (Bastyr ’94), with an office since 1997 in Michigan’s rural Upper Peninsula on the shores of beautiful Lake Superior, promotes our Nature devoted profession through consultation, writing and mentoring. She is joined by Bastyr grad, former mentoree and Pediatric specialist, Alicia Smith Dambeck, LAc CH (also ad locum in St. Paul with Amy Johnson Grass, ND). Since 2011, Dr. Katy has been ad locum herself in SW FL for family matters.
References:
- Morton, W, Enerson, OD. Biography of Thomas George Morton. Whonamedit. Available at: http://www.whonamedit.com/doctor.cfm/2324.html. Accessed April 12, 2015.
- Vanderheiden, T. Morton’s Neuroma: Common Cause of Foot Pain. AboutHealth. 2014. Available at: http://foothealth.about.com/od/neuroma/a/mortonsneuroma.htm. Accessed April 12, 2015.
- Reflexology-Mapcom. Available at: http://reflexology-map.com/wp-content/uploads/2013/03/feet-reflexology-map.jpg. Accessed April 15, 2015.
- Ketcham, S. How Does Reflexology Work?. eHow. 2008. Available at: http://www.ehow.com/how-does_4687024_reflexology-work.html. Accessed April 19, 2015.
- Stomach bloating and shortness of breath. medhelp. 2008. Available at: http://www.medhelp.org/posts/gastroenterology/stomach-bloating-and-shortness-of-breath/show/458213#post_2642096. Accessed April 17, 2015.
- Rose, J. Aching Foot or Morton’s Neuroma. Jeanne Rose Aromatherapy & All Things Herbal. 2008. Available at: http://www.jeannerose.net/articles/mortonsneuroma.html. Accessed April 17, 2015.
- Single Oils. Edens Garden. Available at: http://www.edensgarden.com/collections/single-oils. Accessed April 17, 2015.
