Morton’s Neuroma is also referred to as Morton’s Metatarsalgia, Morton’s Neuralgia or plantar neuroma. It is foot pain experienced in the third interspace, and in the first, second and fourth interspaces. Patients will describe the pain in the foot as radiating from the interspace to adjacent digits quite similar to “pins and needles” tingling accompanied by loss of sensation in the toes. Causes of Morton’s neuroma are certain types of over-pronation and a pivoting of the third or fourth metatarsals that result in a shearing force. This also causes sore foot and inflammation. The sore feet can sometimes be relieved by removing footwear.
A neuroma is growth or a non-malignant tumor that develops in nerve cells. A Morton’s neuroma is an inflamed nerve between the bones at the ball of the foot. Its most common location would be the 2nd or 3rd spacing from the big toe.
Morton’s neuroma is developed from an injury to the nerve between the toes which result in thickening and sore foot. The most commonly affected nerve is the one that travels between the third and fourth toes. While this condition is called a “neuroma”, it is not considered by many as a true tumor but more of a fibrous tissue formation around the nerve tissue.
Patients exhibit symptoms such as foot pain when bearing weight, oftentimes after a short period of time. The degree and nature of pain in the feet varies. Some people feel pain shooting up from the contiguous halves of two toes while there are others who describe the pain ithe the foot as similar to having a pebble in the shoe while walking or walking on razor blades. Common symptoms also include toe cramps, burning sensations, and paresthesia.
Morton’s neuroma patients have difficulty walking or performing activities that put stress or weight on the foot such as pressing on the gas pedal of a car or riding a bicycle. Certain types of shoes such as high-heeled shoes would also be difficult to wear.
Causes and Risk Factors
Morton’s neuroma occurs more in women than in men. While the exact cause of this condition is unknown, some factors are believed by experts to be significant in its development:
- Abnormal position of toes
- Flat foot
- Other foot problems like bunions and hammer toes
- High foot arches
- Wearing tight and ill fitting shoes and high heels.
A physical examination of the foot and an x-ray may be performed to diagnose the problem. An x-ray will also rule out other bone problems. An MRI or ultrasound can also diagnose Morton’s Neuroma. Blood tests may also be used to check inflammation related conditions and arthritis.
Initially, general practitioners explore non-surgical treatments such as:
- Padding of the toe area
- Wearing shoe inserts or foot orthotics
- Wearing shoes with wider toe boxes
- Anti-inflammatory medications taken orally or by injection
- Injecting nerve- blocking medicines in the toe area
- Pain relief medications
- Physical therapy
Gentle massage of the affected interspace can help to relieve pain in the foot. Foot orthotics can also be recommended for treatment of a neuroma. Neuroma pads can be used if orthotics don’t provide relief.
There are cases that would require surgery to eliminate the thick tissue. Removal would relieve the pain in the feet and improve function. While the numbness would be permanent after surgery, it would not be painful.