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Morton’s Neuroma

Morton’s neuroma is an excruciating disorder occurring in the ball of the foot, mainly between the 3rd and 4th toes. It often feels like you’re stepping on a pebble or a fold in your sock. This condition is associated with the thickening of the tissue surrounding a nerve that runs to the toes.

Symptoms of Morton’s Neuroma

People with Morton’s neuroma may experience one or more of the following symptoms in the affected area:

  • Pain
  • Burning, tingling, or numbness in the toes
  • A sensation of something present in the ball of the foot
  • A feeling as if your sock is bunched up or there’s an object in your shoe

Progression of symptoms

Morton’s neuroma symptoms normally develop gradually and follow a predictable pattern:

  • Early stage. Symptoms appear occasionally, frequently triggered by narrow-toed shoes or specific activities.
  • Temporary relief. Discomfort may subside with foot massage, taking off the shoe, or avoiding aggravating footwear and activities.
  • Worsening over time. Symptoms become more persistent, lasting for days or even weeks.
  • Chronic stage. As the neuroma enlarges, symptoms intensify, and temporary nerve changes may be permanent.

Causes and Risk Factors

Morton’s neuroma develops because of irritation, stress, or injury affecting one of the nerves leading to the toes. Some of the risk factors associated with the occurrence of Morton’s neuroma include:

  • High heels & tight shoes: Footwear that is too tight or has a high heel increases stress on the toes and ball of the foot.
  • Certain sports: High-impact activities like running or jogging can subject the feet to repeated trauma. In addition, sports requiring tight-fitting shoes, like rock climbing or skiing, may contribute.
  • Foot deformities: A neuroma may develop due to altered foot mechanics caused by bunions, high arches, hammertoes, or flat feet.

Diagnosis

Morton’s neuroma is mostly diagnosed through:

Physical examination

During a physical exam, the physician will press on the foot to check for tenderness or a noticeable mass. A distinct “clicking” sensation between the foot bones may also be assessed.

Imaging tests

Your doctor may recommend these imaging tests to confirm the diagnosis and rule out other conditions:

  • X-rays: Helps rule out other potential causes of foot pain such as stress fractures.
  • Ultrasound: Employs sound waves to produce real-time images of inner components. This makes it particularly effective for detecting soft tissue defects like neuromas.
  • Magnetic resonance imaging (MRI): Provides detailed soft tissue imaging using powerful magnetic fields and radio waves. Nonetheless, it is costly and may sometimes detect neuromas even in individuals without symptoms.

Treatment for Morton’s Neuroma

Your doctor will evaluate the duration and extent of your condition in order to create a suitable treatment plan for Morton’s neuroma. Treatment options may include:

Nonsurgical treatments:

For mild to moderate cases, nonsurgical options may include:

  • Padding: Special padding techniques are designed to support the metatarsal arch. This reduces stress on the affected nerve, and minimises discomfort when walking.
  • Icing: Applying an ice pack to the affected part helps decrease swelling and inflammation.
  • Orthotic devices: Customised orthotics provide additional foot support, alleviating stress and nerve compression.
  • Activity modifications: Avoid activities that strain the neuroma repeatedly until symptoms improve.
  • Shoe modifications: Opt for shoes that have a wide toe box and refrain from wearing tight-fitting or high-heeled footwear.
  • Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen might help relieve pain and inflammation.
  • Injection therapy: Cortisone shots, local anaesthetics, or other agents may be injected to reduce pain and swelling.

Surgical procedures:

If nonsurgical treatments do not provide relief, your physician may recommend these surgical options:

  • Decompression surgery: This procedure involves cutting adjacent structures like ligaments connecting the bones to relieve pressure on the affected nerve.
  • Nerve removal: In severe cases, surgical removal of the affected nerve may be necessary. While frequently effective, this procedure can lead to irreversible numbness in the affected toes.

Conclusion

The discomfort that comes with Morton’s neuroma can be very frustrating, but you don’t have to endure it alone. With the right care and treatment, you can regain pain-free movement as well as enjoy your daily activities.

If you have concerns about your foot health, schedule an appointment with our specialists today. Let us help you find the best solution for lasting relief and improved mobility.