Morton’s Neuroma: Diagnosis and Comprehensive Treatment Options

Morton’s neuroma is a painful condition that affects the ball of the foot, most commonly between the third and fourth toes. It occurs when the tissue around one of the nerves leading to the toes thickens, causing pain, numbness, or a burning sensation. While not a serious condition, it can significantly impact mobility and quality of life. In this blog, we’ll explore the causes, symptoms, and effective treatment strategies for Morton’s neuroma.

What is Morton’s Neuroma?

Morton’s neuroma is a benign growth of nerve tissue in the ball of the foot, typically affecting the nerve between the third and fourth metatarsal bones. This thickening results from irritation or compression of the nerve, leading to pain and discomfort. It is not a tumour but rather an inflammation and fibrotic change around the nerve.

Causes of Morton’s Neuroma

The exact cause of Morton’s neuroma is unclear, but several factors can contribute to its development:

Footwear:
- Wearing tight, narrow, or high-heeled shoes can compress the toes and irritate the nerve.
Biomechanical Abnormalities:
- Conditions such as flat feet, high arches, or bunions can alter foot mechanics, increasing pressure on the nerve.
Repetitive Trauma:
- Activities like running or sports that involve repetitive forefoot impact can aggravate the nerve.
Foot Deformities:
- Structural abnormalities in the foot can predispose individuals to Morton’s neuroma.

Symptoms of Morton’s Neuroma

The symptoms of Morton’s neuroma can vary in intensity but typically include:

Pain in the Ball of the Foot:
- A sharp, burning pain between the toes, often worse when walking or wearing tight shoes.
Numbness or Tingling:
- A sensation of numbness or tingling in the toes.
Feeling of a Lump:
- Some people describe a sensation of standing on a pebble or a folded sock.
Symptoms Relieved by Rest:
- Pain may improve when shoes are removed, or pressure on the foot is relieved.

Diagnosing Morton’s Neuroma

A diagnosis is usually made based on a physical examination and the patient’s history. Key diagnostic steps include:

Clinical Examination:
- A doctor may press on the foot to identify the location of pain and assess for a palpable lump.
Imaging Studies:
- Ultrasound or MRI may be used to confirm the diagnosis and rule out other conditions like stress fractures or arthritis.

Treatment Options for Morton’s Neuroma

Treatment focuses on reducing nerve irritation and relieving pain. Options range from conservative measures to surgical interventions:

1. Conservative Treatments

Footwear Modifications:
- Switch to shoes with a wide toe box and good arch support to reduce pressure on the nerve.
Orthotics:
- Custom orthotics or metatarsal pads can redistribute weight and relieve nerve compression.
Activity Modification:
- Avoid activities that exacerbate symptoms, such as running or high-impact sports.
Pain Relief:
- Over-the-counter pain relievers like ibuprofen can help reduce inflammation and pain.

2. Advanced Non-Surgical Treatments

Corticosteroid Injections:
- Injections can reduce inflammation and provide temporary relief.
Alcohol or Radiofrequency Ablation:
- These techniques target the nerve to reduce pain without surgery.
Shockwave Therapy:
- Stimulates healing and reduces pain in chronic cases.

3. Surgical Intervention

If conservative and non-surgical treatments fail, surgery may be recommended. Options include:

Neurectomy:
- The inflamed nerve is surgically removed. This is typically effective but may result in permanent numbness in the affected toes.
Decompression Surgery:
- The surgeon releases ligaments or structures pressing on the nerve to alleviate pain.

Recovery from surgery can take several weeks to months, but most patients experience significant pain relief.

Preventing Morton’s Neuroma

While not all cases are preventable, these steps can reduce your risk:

Wear Proper Footwear:
- Choose shoes with a wide toe box, good cushioning, and arch support.
Avoid Prolonged Heel Use:
- Limit wearing high heels to reduce forefoot pressure.
Strengthen Foot Muscles:
- Regular exercises, such as toe stretches and foot strengthening, can improve foot mechanics.
Gradual Activity Progression:
- Avoid sudden increases in high-impact activities that strain the forefoot.

When to Seek Medical Attention

Seek professional care if you experience persistent pain in the ball of your foot, numbness, or a feeling of walking on a lump that does not improve with rest or footwear changes. Early intervention can prevent the condition from worsening.

Conclusion: Finding Relief from Morton’s Neuroma

Morton’s neuroma can be painful and disruptive, but with proper diagnosis and treatment, most individuals find significant relief. From conservative measures like footwear changes to advanced therapies and surgical options, there are many ways to address this condition and restore comfort and mobility.

At MSK Doctors, we specialise in diagnosing and treating foot and ankle conditions like Morton’s neuroma. Contact us today to discuss your symptoms and explore personalised treatment options.

FAQ Section

What is Morton’s neuroma?
Morton’s neuroma is a thickening of the tissue around a nerve in the ball of the foot, causing pain and discomfort.

What causes Morton’s neuroma?
Common causes include tight footwear, repetitive trauma, foot deformities, and biomechanical issues.

How is Morton’s neuroma treated?
Treatment options range from conservative measures like footwear changes and orthotics to advanced therapies such as corticosteroid injections and surgery.

Can Morton’s neuroma heal on its own?
Mild cases may improve with rest and lifestyle changes, but persistent symptoms often require medical intervention.

When should I see a doctor for Morton’s neuroma?
If pain persists despite conservative measures or interferes with daily activities, seek medical advice.

Can Morton’s neuroma be prevented?
Wearing proper footwear, avoiding high heels, and strengthening foot muscles can reduce the risk of developing this condition.