A Morton’s neuroma is a benign (noncancerous) swelling along a nerve in the foot that carries sensations from the toes. The reason the nerve starts to swell is unknown. But once swelling begins, the nearby bones and ligaments put pressure on the nerve, causing more irritation and inflammation. This produces burning pain, numbness, tingling and other abnormal sensations in the toes. A Morton’s neuroma also is called an interdigital neuroma, intermetatarsal neuroma or a forefoot neuroma.
Morton’s neuroma may be the result of irritation, pressure or injury. In some cases its cause is unknown. In the majority of cases only one nerve is affected. Having both feet affected is extremely rare. A high percentage of patients with Morton’s neuroma are women who wear high-heeled or narrow shoes. Patients with Morton’s neuroma may need to change their footwear, take painkillers or steroid injections, while others may require surgery to either remove the affected nerve or release the pressure on it.
Symptoms typically include pain, often with pins and needles on one side of a toe and the adjacent side of the next toe. Pain is made worse by forefoot weight bearing and can also be reproduced by squeezing the forefoot to further compress the nerve. Pressing in between the third and forth metatarsals for example with a pen can also trigger symptoms.
Your health care provider can usually diagnose this problem by examining your foot. A foot x-ray may be done to rule out bone problems. MRI or ultrasound can successfully diagnose the condition. Nerve testing (electromyography) cannot diagnose Morton neuroma. But it may be used to rule out conditions that cause similar symptoms. Blood tests may be done to check for inflammation-related conditions, including certain forms of arthritis.
Non Surgical Treatment
Wearing shoes that provide enough room in the toe box is also the first step in treating Morton?s neuroma. For instant relief when pain flares up, try taking your shoes off and rubbing the area. The nerve can get trapped below the ligament, and rubbing can move it back to its natural position. Your doctor or a foot-care specialist may recommend lower heels and metatarsal pads. These pads provide cushioning under your neuroma and better arch support to redistribute your weight. If you keep pressure off the toes and wear wide enough shoes, the problem may gradually disappear.
If conservative treatments haven’t helped, your doctor might suggest injections. Some people are helped by the injection of steroids into the painful area. In some cases, surgeons can relieve the pressure on the nerve by cutting nearby structures, such as the ligament that binds together some of the bones in the front of the foot. Surgical removal of the growth may be necessary if other treatments fail to provide pain relief. Although surgery is usually successful, the procedure can result in permanent numbness in the affected toes.