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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Nociception—the ability to feel pain—is essential for an organism’s survival and overall well-being. Noxious stimuli such as piercing pain from a sharp object, heat from an open flame, or contact with corrosive chemicals are first detected by sensory receptors, called nociceptors, located on nerve endings. Nociceptors express ion channels that convert noxious stimuli into electrical signals. When these signals reach the brain via sensory neurons, they are perceived as pain.
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Morton's neuroma - Current concepts review.

Maneesh Bhatia1, Lauren Thomson1

  • 1University Hospitals Leicester, UK.

Journal of Clinical Orthopaedics and Trauma
|May 15, 2020
PubMed
Summary

Morton's neuroma, a forefoot nerve fibrosis, results from pressure. Treatment includes orthotics, injections, or surgery, with careful patient selection and technique crucial for success.

Area of Science:

  • Podiatry
  • Orthopedic Surgery
  • Neurology

Background:

  • Morton's neuroma is a common forefoot condition characterized by nerve fibrosis, not a true neuroma.
  • It arises from nerve compression or irritation, typically in the second or third intermetatarsal spaces.
  • This condition involves digital nerve thickening due to repetitive stress.

Purpose of the Study:

  • To summarize the etiology, clinical presentation, and management of Morton's neuroma.
  • To highlight key factors for successful treatment outcomes.
  • To provide an overview of current therapeutic strategies.

Main Methods:

  • Review of existing literature on Morton's neuroma.
  • Analysis of common diagnostic and treatment approaches.
Keywords:
Morton’s neuroma foot forefoot pain digital nerve

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  • Emphasis on clinical examination and surgical considerations.

    • Main Results:

    • Non-neoplastic fibrosis of the digital nerve is the primary pathology.
    • Conservative treatments like orthotics and steroid injections are initial options.
    • Surgical excision via a dorsal approach is a definitive treatment.

    Conclusions:

    • Successful management of Morton's neuroma relies on accurate diagnosis and patient selection.
    • Pre-operative counseling and meticulous surgical technique are vital for optimal results.
    • Understanding the condition as nerve fibrosis guides effective treatment strategies.