Overview

What is Morton's neuroma?

Morton's neuroma is a harmless lesion but painful condition that affects the ball of the foot's also known as an intermetatarsal neuroma because of its location in the metatarsal ball or between metatarsal bones.

The tissue swelling around the nerve eventually leads to a toe because of irritation or compression. Most cases are between the third and fourth toes, but they can also be found between the second and third. It mostly affects middle-aged people, but the female gender is more commonly involved than males.

What are the symptoms of Morton's neuroma?

Common signs and symptoms of Morton's neuroma include:

Pain between your toes when you stand or walk.
Pain that worsens when you wear high-heeled shoes or stand on the balls of your foot.
Swell between your toes.
Numbness, particularly in a distribution pattern referred to as stocking and glove.

Most patients experience pains that get worse with time. Even in the early stages, there can be merely minimum pain that is relieved by resting or removing your shoe and massaging your foot. Since the inflammation on the nerve is not a static figure, you may start noticing that your symptoms are getting worse.

What causes Morton's neuroma?

Morton's neuroma develops when the nerve between your toe bones is irritated and swells. The cause of inflammation is rarely known, but experts believe that the most common cause is pressure that affects your toes and the nerves between them, as well as your foot's ball area.

Some activities increase your chance of developing a Morton's neuroma. These include:

Wear high heels or shoes that have a narrow, pointed toe.
If you participate in a high-pressure sport that involves the balls of your feet, such as running, tennis, or other racquet sports.
You work physically and stand all day.

There are some health-related problems which put you at a higher risk for developing Morton's neuroma, including the following:

Flat feet
High arch feet
Bunions
Hammertoes
Injuries to the feet- any kind of foot injury, such as sports or trauma.

How is Morton's neuroma diagnosed?

A doctor diagnoses Morton's neuroma with a physical exam. You may be referred to a podiatrist, a doctor who specializes in caring for your feet.

Your provider will examine your feet. Let your provider know when you first began to experience symptoms and if certain activities or positions make them worse.

Your provider will lightly press on the spaces between your toe bones. They may then ask you to stand, walk, or move.

Which tests are used to diagnose Morton's neuroma?

Your doctor can sometimes diagnose Morton's neuroma through symptoms and examination. A foot X-ray will not show a neuroma; however, it may be helpful to rule out common causes of foot pain, such as a stress fracture or arthritis, in some way.

An ultrasound might be taken by the doctor of your nerve and around tissue for you to ascertain the problem. With this, the doctor can take pictures of the nerve and the surrounding areas. The electromagnetic activity cannot be ascertained by an ultrasound; hence, the doctor will advise on doing an electromyography procedure. This test measures the electrical activity in your nerves and muscles that help rule out conditions that have nerve damage as symptoms, for example, that of Morton's neuroma.

What is the best treatment for Morton's neuroma?

Your doctor will recommend treatments to help your symptoms and reduce swelling within your involved nerve.

The major treatment options for Morton's neuroma are:

Changing Footwear: Changing to shoes with wide, deep toe boxes may serve to relieve pressure on your affected nerve. You might even use a stretching device to widen the shoes you already have.
Shoe Pads: You can purchase OTC shoe pads that cushion the area around your nerve and relieve pressure.
Orthotic devices: An orthosis is a shoe insert that supports the feet and keeps the toes in the proper position. You may need to buy it over the counter or even have it made to order.
Pain relievers: NSAIDs reduce pain and swelling. Do not take NSAIDs for more than ten consecutive days without consulting your provider.
Icing: Apply ice or a cold pack to the painful foot to reduce pain and inflammation. Cover the cold pack with a thin towel so that you are not in contact with it.
Corticosteroids: Corticosteroids are another prescription medication that reduces inflammation, and you would probably have to take cortisone injections.

Morton's neuroma surgery

Most people do not need surgery to treat Morton's neuroma. Your physician may therefore suggest some surgical intervention where other treatment interventions cannot offer adequate relief of pain, and also where the pains are severe but only for those walking. Your doctor or surgeon can discuss what type of surgery will be needed and what to expect during the procedure.

The most common procedures used include:

Neurectomy: A neurectomy is probably the most common surgery performed for Morton's neuroma. The surgeon will remove part of the affected nerve.
Cryogenic neuroablation employs extreme cold to kill a specific number of neurons, reducing the inflammation and sensitivity of the nerve.
Radiofrequency ablation: To treat Morton's neuroma, surgery destroys a small portion of the affected nerve tissue with heat. This stops the pain signals from traveling back to the brain.

Can I prevent a Morton's neuroma?

You can take precautions to avoid developing a Morton's neuroma:

Avoid wearing tight or high-heeled shoes for a long time.
Wear wide-toe box shoes so that your toes are not cramped or forced out of their position.
Wear athletic shoes with lots of cushioning between the balls of your feet and the bottom of the shoe if you are more active.
Exercise in ways that are lower-impact, or work with a coach or trainer to modify your activities to place less pressure on your feet.
Healthy by diet and exercise plans.

What are the expectations during a Morton's neuroma?

Most patients with Morton's neuroma find a combination of treatments that will alleviate their symptoms. Once the nerve in question has subsided from its inflammation, you should be able to get back to all your normal activities with no pain involved. You may have to switch between different types of shoes or which kinds of physical activities you do, but you shouldn't be faced with long-term ramifications after having Morton's neuroma.