Morton’s Neuroma

A neuroma is a thickening of nerve tissue that may develop in various parts of the body. Morton’s neuroma is a painful condition that affects the ball of the foot, most commonly the area between the third and fourth toes. Morton’s neuroma may feel as if there is a pebble in a shoe or a fold in a sock.

The thickening of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression enlarges the nerve, eventually leading to permanent nerve damage.

Causes

Anything that causes compression or irritation of the nerve can lead to the development of a neuroma. One of the most common offenders is wearing shoes that have a tapered toe box or high-heeled shoes that cause the toes to be forced into the toe box. Patients with foot deformities are at a higher risk of developing a neuroma. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running or court sports. An injury or other type of trauma to the area may also lead to a neuroma.

The progression of Morton’s neuroma often follows this pattern:

• The symptoms begin gradually. At first, they occur only occasionally when wearing narrow-toed shoes or performing certain aggravating activities.
• The symptoms may go away temporarily by removing the shoe, massaging the foot or avoiding certain activities.
• Over time, the symptoms progressively worsen and may persist for several days or weeks.
• The symptoms become more intense as the neuroma enlarges and as these temporary changes to the nerve become permanent.

Symptoms

Morton’s neuroma involves a thickening of the tissue around one of the nerves leading to your toes. This can cause a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb

Contact a doctor if you notice one or more of these symptoms:

• Tingling, burning or numbness
• Pain
• It feels as if something is inside the ball of your foot
• It feels as if something is in your shoe or as if your sock is bunched up.

Potential Treatments

To arrive at a diagnosis, your doctor will need a thorough history of your symptoms and examine your foot. During a physical examination, your doctor may attempt to reproduce your symptoms by manipulating your foot. Other tests or imaging studies may be performed

The best time to contact a doctor is while the symptoms are still in the early stages of development. Early diagnosis of Morton’s neuroma may help you avoid the need for corticosteroid injections or surgery.