What Causes Morton's Neuroma?

Morton's neuroma can be caused by shoes that are too tight or from high heels. Excessive nerve compression on the foot can lead to Morton's neuroma. Pre-existing foot or gait abnormalities such as bunions, high arches, flat feet, or hammer toes, may also lead to the condition due to instability and additional pressure on foot nerves.

Athletes may also develop Morton's neuroma from repetitive trauma on the ball of the foot caused by running or racquet sports. Activities that require tight footwear, such as skiing or ballet, also increase risk.

Morton's Neuroma Symptoms

The most common Morton's Neuroma symptoms are:

• Burning pain in the ball of the foot. Some people describe the pain as if they are perpetually standing on a marble in their shoe.
• Numbness in the toes. Walking may be painful and difficult. However, there will not be noticeable swelling in the foot. Some people report a tingling feeling.
• Sharp pain — or a dull irritation — in the nerve tissue connecting the third and fourth toes.

Symptoms often appear gradually, and pain will begin to intensify during athletic ventures or while wearing narrow-toed shoes. As the neuroma enlarges, the symptoms will become more chronic and uncomfortable.

How Is Morton's Neuroma Diagnosed?

The first step in diagnosing Morton's neuroma is a physical examination. If you start experiencing symptoms, it is best to schedule a physical inspection as soon as possible before the condition worsens and more aggressive treatments will be required.

A qualified foot and ankle surgeon will examine the foot and try to reproduce symptoms by moving it around and observing how the patient walks. Thorough imaging will also help physicians diagnose the condition. X-rays will help rule out other possible reasons for symptoms, such as a stress fracture. Ultrasounds will help identify abnormalities in the soft tissue, while magnetic resonance imaging (MRI) will help reveal a better visual of the soft tissues in the foot.

Morton's Neuroma Treatment Options

Treatment approaches depend on the development and severity of Morton's neuroma. For mild or moderate cases, a physician will recommend a change in footwear. Avoid high heels or tight shoes, and wear wider shoes with lower heels and a soft sole. This enables the bones to spread out and may reduce pressure on the nerve, giving it time to heal. Custom shoe inserts and pads also help relieve irritation by lifting and separating the bones, reducing the pressure on the nerve.

Adequate padding on the metatarsal arch will support and lessen the pressure on the foot nerves, decreasing compression while walking. Icing the afflicted area will reduce swelling, and the patient should refrain from athletic activities until the condition improves.

Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, will relieve pain, while corticosteroid medication can reduce the swelling and inflammation of the nerve, bringing some relief. Several studies have shown that a combination of roomier, more comfortable shoes, nonsteroidal anti-inflammatory medication, custom foot orthoses, and cortisone injections provide relief in over 80 percent of people with Morton's Neuroma.

If therapies do not work and symptoms continue after 9 to 12 months, surgery may help your condition. Procedures like the excision of Morton's neuromas can alleviate the pain by releasing pressure from the nerve. Your doctor will be able to recommend an appropriate treatment for your condition.

Learn more about the Foot and Ankle Center at Resurgens Orthopaedics.