What Is Morton's Neuroma?
Morton's neuroma is a painful condition affecting the ball of your foot, most
commonly the area between your third and fourth toes. It involves thickening of
the tissue around one of the nerves leading to your toes, caused by compression
and irritation.
Despite the name, a neuroma isn't actually a tumor. It's a benign thickening
of nerve tissue that develops in response to irritation, pressure, or injury.
While it can be quite painful, Morton's neuroma is very treatable.
Symptoms
- Feeling like you're standing on a pebble or fold in your sock
- Sharp, burning pain in the ball of the foot
- Pain that radiates into the toes
- Tingling or numbness in the affected toes
- Pain that worsens with activity or wearing tight shoes
- Relief when removing shoes and massaging the foot
Interestingly, there's typically no visible lump or swelling on the outside
of the foot with a neuroma.
Causes and Risk Factors
- High Heels: Shoes that put pressure on the forefoot
- Tight, Narrow Shoes: Compressing the toes together
- High-Impact Activities: Running, court sports, and other activities that stress the forefoot
- Foot Deformities: Bunions, hammertoes, flat feet, or high arches
- Occupation: Jobs requiring tight footwear or prolonged standing
Diagnosis
Dr. Johnson will perform:
- Physical Examination: Pressing on the foot to locate the painful area and checking for a "click" (Mulder's sign)
- Discussion of Symptoms: Understanding your pain pattern and footwear
- X-rays: To rule out other conditions like stress fractures
- Ultrasound or MRI: May be used to confirm the diagnosis if needed
Treatment Options
Conservative Treatment
Most neuromas respond well to non-surgical treatment:
- Proper Footwear: Shoes with a wide toe box and low heels
- Metatarsal Pads: Reduce pressure on the nerve
- Custom Orthotics: Address underlying foot mechanics
- Icing: Reduce pain and inflammation
- Activity Modification: Avoiding activities that aggravate symptoms
- Anti-inflammatory Medications: Short-term pain relief
- Corticosteroid Injections: Reduce inflammation around the nerve
- Alcohol Sclerosing Injections: Shrink the nerve tissue over time
Surgical Treatment
If conservative treatments don't provide adequate relief, surgery may be
recommended. Surgical options include:
- Neurectomy: Removing the affected nerve tissue
- Decompression Surgery: Releasing the structures that compress the nerve
Surgery is typically performed as an outpatient procedure with a relatively
quick recovery, though some numbness in the toes may occur after neurectomy.
Prevention
- Wear shoes with plenty of room for your toes
- Avoid high heels or limit the time spent wearing them
- Choose shoes with good cushioning in the forefoot
- If you participate in sports, wear proper athletic shoes
- Consider custom orthotics if you have foot deformities
- Maintain a healthy weight to reduce pressure on your feet