What is Morton’s Neuroma?

By Rehan Iqbal

Morton’s neuroma is also called inter-metatarsal neuroma because it is the thickening of nerve tissue between the metatarsal bones of the foot. This very common form of nerve damage usually happens between the third toe and the fourth toe at the ball of the foot. It can also develop between the second and third toe. In this article, we describe this painful condition and offer sound advice on preventing and treating Morton’s neuroma. Read on to learn more….

What Causes Morton’s Neuroma?

This thickening of the nerves is the result of nerve irritation which happens when the bones of the foot are squeezed together by improperly fitted footwear. This causes the nerve to become calloused and to grow thicker.

In addition to poorly fitted footwear, such as high heels and/or shoes that have a very tapered toe box, Morton’s neuroma can also be caused or exacerbated a variety of foot deformities. For example people who have very flexible feet, flat feet, hammer toes and bunions are far more prone to develop neuromas than people who do not suffer from these conditions. Also people who have experienced injury to the foot may develop neuromas.

Furthermore, people who participate in very active sports that involve a lot of repetitive movements and stress on the feet are prone to develop neuromas. Morton’s neuroma is a common problem for runners and people who participate in court sports.

What Are The Symptoms Of Morton’s Neuroma?

When you first notice a neuroma, you may feel as if you have a wrinkle in your sock or a pebble in your shoe. You may also feel as if there is something inside your foot at the ball of the foot. Other symptoms include numbness, burning, tingling and pain.

Your symptoms may begin a little bit at a time. You may only have pain, numbness, tingling and so forth when you are wearing shoes with very narrow toes or high heels or when you are engaged in certain athletic activities. When you take your shoes off, rub your feet or change your shoes, your symptoms may go away temporarily.

Without proper treatment, though, as time passes your symptoms may grow worse and worse and may become quite persistent. In fact, you may feel no relief for periods of days or weeks on end. If you continue to go without treatment, the damaged nerve will become more enlarged, your symptoms will worsen and the damage to the nerve can become permanent.

How Do You Know You Have Morton’s Neuroma?

Because there are several different foot conditions that can cause ball of foot pain, it’s important to see your doctor or podiatrist for a proper diagnosis. Your doctor will review your medical history, perform a physical exam and especially examine your feet. Your doctor may manipulate your foot or have you perform certain activities in an attempt to reproduce the symptoms.

It’s important that you see your doctor right away when you begin to develop symptoms because you may be able to reverse the effects of Morton’s neuroma with early treatment. More importantly, you may be able to avoid surgery.

What Are Some Noninvasive Treatments for Morton’s Neuroma?

There are a number of things you can do on your own and/or with the advice of your doctor or podiatrist. Try some of these simple therapies to gain relief:

Use padding: Choose over-the-counter footpads to provide some support for your metatarsal arch. Supporting the arch reduces the pressure on the irritated nerve. It also decreases compression while you are walking.
Try custom orthotic devices: If over-the-counter orthotic devices don’t help, talk with your doctor or your podiatrist about having orthotics custom-made. These products are quite expensive, but can provide complete relief.
Modify or change your shoes: Throw out all of your high heels and shoes that have pointy toes. If you have Morton’s neuroma you will need to have shoes that provide plenty of wiggle room for your toes and do not place any pressure at all on the bones of your feet. Good padding and support is also absolutely essential.
Modify your activities: When you have identified activities that hurt your feet, stop doing them! Give your feet a complete rest until your current condition improves and your pain is resolved. Only then should you attempt to return to the activity that has caused your pain. Do so carefully and with input and advice from your doctor or podiatrist. Modify the activity to avoid a repeat of your symptoms
Apply ice: While you’re at rest with your feet elevated, put an icepack on your sore foot. It will help reduce the pain and the swelling.
Try pain meds: Sometimes over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve the pain. Try ibuprofen, aspirin or other simple pain reducing anti-inflammatory drugs.
Injection therapy may help: If none of the suggestions mentioned so far provide relief, talk with your doctor about injection therapy. He or she may agree to inject local anesthetics or cortisone at the site of the pain. This may be very helpful.

Can Surgery Be Avoided?

Keep in mind that you did not develop Morton’s neuroma overnight, so it will take patience and persistence to resolve your foot pain using noninvasive methods. Stay in close communication with your doctor or your podiatrist and be consistent in applying the tips mentioned here and the recommendations of your medical professional.

If you experience little or no relief after giving these methods a very serious trial of several months, you may need to have surgery. Your doctor, podiatrist or foot and ankle surgeon can review the types of surgery that would be appropriate for you and help you make an educated choice.