Morton’s Neuroma
Definition
A Morton’s neuroma is a benign growth of the nerve sheath of a nerve that courses between the toes. This condition is an abnormal growth, but it is not a cancer that can become a dangerous condition. Rather, the Morton’s neuroma can become a painful nuisance. Occasionally, people may also experience symptoms of shooting pains or tingling extending into the toes adjacent to the neuroma. Pain is usually most significant with more strenuous activity and when wearing constricting shoes.
Morton’s neuroma involves a thickening of the tissue around one of the nerves leading to your toes. In some cases, Morton’s neuroma causes a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb.
Causes
Morton’s neuroma is an inflammation caused by a buildup of fibrous tissue on the outer coating of nerves. This fibrous buildup is a reaction to the irritation resulting from nearby bones and ligaments rubbing against the nerves.
Irritation can be caused by:
• Wearing shoes that are too tight
• Wearing shoes that place the foot in an awkward position (eg, high heels)
• A foot that is mechanically unstable
• Repetitive trauma to the foot (such as from sports activities like tennis, basketball, and running)
• Trauma to the foot caused by an injury (such as a sprain or fracture)
It is unusual for more than one Morton’s neuroma to occur on one foot at the same time. It is rare for Morton’s neuroma to occur on both feet at the same time.
Treatment and Prevention
Treatment
If your Morton’s neuroma is painful, your doctor usually will begin treatment with conservative therapies, including:
• A switch to shoes with low heels, wide toes and good arch support
• Padding techniques, including metatarsal pads or toe crest pads
• Shoe inserts (orthotics) to help correct any mechanical imbalance in the foot
• Anti-inflammatory medication, such as ibuprofen (Advil, Motrin and other brand names) or naproxen (Aleve, Naprosyn and other brand names)
• A local injection of anesthetic and corticosteroid medication into the affected area
Inflamed or injured nerves can take months to improve, even after the underlying problem has been corrected. If your pain continues despite several months of conservative treatment, your doctor may recommend surgery to remove the neuroma or to widen the space through which the affected nerve travels. These types of surgery often are done under local anesthesia. If your doctor removes a portion of the affected nerve along with the neuroma, you may develop permanent numbness between the toes.
Prevention
It is not always possible to prevent a Morton’s neuroma. However, you probably can reduce your risk by wearing comfortable shoes that have low heels, plenty of toe space and good arch support.
Steps to help prevent Morton’s neuroma include:
• Avoid wearing tight and/or high-heeled shoes.
• Maintain or achieve ideal body weight.
• If you play sports, wear roomy, properly fitting athletic footwear.
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