Morton’s Neuroma

Overview

Morton’s Neuroma is a thickening of the tissue around nerves leading to the toes. The condition was first described by a chiropodist named Durlacher but is named after Dr. Thomas George Morton.

This condition is relatively common, with over 200,000 cases in the U.S. every year. It can be caused by pressure (from running or use of high heels) or injury.

Morton’s Neuroma may cause a sharp, burning pain or numbness in the ball of the foot or toes, or it can feel like there’s a pebble in your shoe or a fold in your sock.

Treatments include arch supports, footpads, corticosteroid injections, strength exercises, special shoes, and surgery.

Anatomy

Your feet are comprised of many bones, muscles, and soft tissues such as tendons and ligaments. Additionally, they contain many nerves.

A large group of nerves surrounds your toe bones (the metatarsals). Occasionally, the tissues near these nerves thicken and form a growth called a neuroma.

Under different circumstances, neuromas can be cancerous tumors. But orthopedists stress that Morton’s variety are benign and are not considered tumors.

Morton’s Neuroma is the official name given this condition, also known as Morton’s metatarsalgia. In most cases, this problem occurs between your third and fourth toe bones.

Causes

Researchers believe these abnormal growths are caused by repeated and intense pressure placed upon nerves. Several underlying factors may increase your risk of developing the condition:

• If you have been diagnosed with any type of foot problem, most notably issues like hammertoes, bunions, or flat feet, your chances of contracting the condition rise significantly.
• People who wear high heel shoes for professional or stylistic purposes. This footwear often places unnecessary strain on the ball of your foot and surrounding toe bones, which can lead to Morton’s Neuroma.
• Sports that place added stress on your feet increases your probability of developing neuromas. Of particular concern are activities such as running, rock climbing, and snow skiing.
• Studies have found that this problem is eight to ten times more likely to occur in women.

Symptoms

There is one common occurrence almost everyone eventually diagnosed with the condition experiences – a feeling that a rock is stuck in the bottom of your shoe or that your sock has a bulge that you cannot seem to straighten. Other notable symptoms include:

• A burning sensation in the ball of your foot.
• Tingling or numbness around the affected toe bones.
• Pain that worsens when wearing tight shoes.
• Discomfort that increases during strenuous activities.
• Pins and needles.
• Reduced sensation of touch.
• Lump in the sole of the foot.
• Sensation of walking on a marble.

Diagnosis

During your physical examination, your physician will thoroughly check the bottom of your foot for any growths. An official diagnosis may not be reached without the use of some diagnostic imaging test such as magnetic resonance imaging (MRI scans), X-rays, or ultrasound.

Though all these tests enable medical professionals to study internal images of your foot, many maintain ultrasound is most effective in detecting soft tissue problems like neuromas.

Treatment Overview

Most minor or uncomplicated cases respond well to simple lifestyle changes or homecare remedies. More severe cases or those causing associated complications (like nerve damage) may need surgery.

Non-Surgical Treatment Options

Common initial therapies include footwear alterations, orthotics, and steroidal injections.

Sometimes, a simple effort such as changing the shoes you wear can result in significant improvement. Using wider, less constricting shoes places far less pressure on your feet’s nerves and toe bones.

Orthotics are soft, cushion-like products inserted into your shoes. This padding is designed to make your shoes more comfortable and place less stress on your feet, which may reduce the chances of developing the nerve irritation often responsible for causing neuromas.

Steroid injections are used on moderate occurrences to reduce swelling and inflammation.

Patients often experience noticeable relief when a combination of these preceding therapies are employed.

Surgical Intervention

The most severe conditions may require surgery. Two types of surgical efforts are commonly undertaken – nerve removal and decompression.

• Nerve Removal – If the growth has grown to significant lengths or is causing considerable nerve damage, removing the neuroma and surrounding nerves may be needed.
• Decompression – Occasionally, more painful instances of the condition can benefit from decompression surgery. Surgeons alleviate pressure on impacted nerves by cutting away sections of other nearby structures like soft tissues.

Next Steps

If you believe you have Morton’s Neuroma and the associated discomfort interferes with your everyday life and activities, please contact us. Our foot specialists have extensive experience diagnosing and treating this condition. Talk to your Florida Orthopaedic Institute physician today to learn more about Morton’s Neuroma.