Morton's neuroma is a prevalent foot condition characterized by nerve pain in the ball of the foot. It occurs when the nerve running between two toes becomes compressed or pinched, leading to pain, numbness, and discomfort. The condition is generally a response to irritation, trauma, or excessive pressure on the foot. Treatment typically includes rest, wearing wider shoes, taking anti-inflammatory medications, and wearing orthotics.
What is Morton's Neuroma?
Also known as an interdigital neuroma, Morton's neuroma is a thickening of the tissue (sheath) that surrounds one of the nerves in your foot. Most often, it develops in the ball of the foot between the third and fourth toes, although it can also occur between the second and third toes. The condition can lead to mild or severe pain in the forefoot that may interfere with walking and other activities.
Who is affected by Morton’s Neuroma?
Women are significantly more likely to experience Morton neuromas than men, and the discomfort typically appears in people between the ages of 30 and 60, though the condition can certainly occur at earlier and older ages. The statistics suggest that women are eight times more likely to be affected by this condition.
What Causes Morton’s Neuroma?
Morton's neuroma is caused by repeated pressure, compression, or squeezing between your toes which irritates and inflames the common digital plantar nerves. Repetitive inflammation of the nerve fibers may cause thickness and potential scar tissue. Morton’s neuroma may also be linked to problems like flat feet and high arches. Problems such as bunions, hammertoes as well as other toe problems may also contribute to the development of Morton’s neuroma. Activities that put a lot of pressure on the balls of your feet, like high-impact running, walking, or playing fast-paced racquet sports, can cause it as well. People who wear tight shoes or those with a narrow toe box and women who wear high heels that compress the toes may also experience Morton’s neuroma. Abnormal bone structure in the foot that causes toe rubbing can be another factor.
Symptoms of Morton’s Neuroma
Morton’s neuroma typically causes sharp, stinging, or burning pain with standing or walking on the affected foot. Some people describe it as feeling as if they are standing on a pebble, or as if there is a lump between the toes. There may be a sensation of clicking or popping between the toes while walking. Pain, if left untreated, may get worse over time. Patients also sometimes experience swelling, tingling, and numbness.
Diagnosing Morton's Neuroma
Your orthopedic specialist will talk with you about your symptoms and perform a physical exam that will include:
- Assessing the skin of your foot and ankle for excessive pressure points and areas that are painful to the touch
- Evaluating the position of the toes and foot to reveal common deformities that may also cause pain in the forefoot
- Putting pressure on the spaces between the toes to try to pinpoint the specific site of the pain
- Assessing the range of motion of the toe joints, as well as other joints, to see if there is an irritation that may suggest arthritis or joint inflammation as a cause of the pain
- Looking for a “Mulder’s click” by squeezing your foot
- X-rays may be required to rule out a stress fracture or arthritis in the joints that connect the toes to the foot. Sometimes, advanced imaging such as an MRI, may be recommended.
Morton's Neuroma Treatment Options
Treatment for Morton's neuroma aims to alleviate pain and improve the condition. The following treatment options are available:
- Wearing comfortable, supportive shoes with a wider toe box (with more room for your toes) helps reduce pressure and alleviate pain
- Resting the affected foot and avoiding activities that worsen the symptoms
- Applying ice and using anti-inflammatory medications to reduce pain and inflammation
- Physical therapy exercises to strengthen the foot and improve flexibility
- Wearing custom orthotics (shoe inserts) or metatarsal pads/bars can aid in relieving pain and irritation by altering the location of the pressure on the forefoot and separating the bones, which reduces the pressure on the neuroma
- Steroid injections can reduce swelling and inflammation of the nerve, bringing some relief
Other treatment methods include nerve ablation (injecting medication to a specific location) which permanently stops the nerve from sending out pain signals to the brain, or in severe cases, where conservative measures fail, surgery may be recommended.
Conclusion
Morton's neuroma is a condition affecting the nerves between the toes, primarily caused by tight-fitting shoes, foot abnormalities, or injuries. Recognizing the symptoms, such as sharp pain, tingling, or a lump between the toes, is crucial for early diagnosis. Treatment options include wearing proper footwear, resting the foot, using ice and medication, undergoing physical therapy, and, if necessary, surgical intervention. Maintaining proper foot care, including exercises to strengthen the feet and wearing comfortable shoes, can help prevent Morton's neuroma. If symptoms develop, seeking medical attention promptly is essential for early intervention and preventing further complications.
Be sure to ask your OrthoConnecticut Foot and Ankle specialist what treatment protocol is right for you.
