Morton’s Neuroma

About Morton’s Neuroma
A neuroma is a benign tumor of the nerve. Morton’s neuroma is not actually a tumor, but a benign growth of nerve tissue or thickening of the tissue that surrounds the digital nerve leading to the toes.It is a painful condition commonly involves the 3rd and 4th toes and can bring on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot. It is interesting to note that the incidence of Morton’s neuroma is higher in women than in men.
(Picture ref. https://www.perthfootcentre.com.au)

 

 

What are some of the signs and symptoms of Morton’s Neuroma?
Normally, there are no outward signs such as a lump as this is not really a tumor. The principle symptom associated with a neuroma is pain between the toes while walking.

 

Most people with Morton’s neuroma generally experiencing the following:

  • Pain in the forefoot and between the toes.

  • Tingling, numbness or an unpleasant feeling in the ball of the foot.

  • Burning pain in the ball of the foot that may radiate into the toes.

  • Swelling between the toes.

  • Pain is generally aggravated with activity or wearing tight, narrow shoes which can compress the toe bones and pinch the nerve. Night pain is rare.


How do you get a Morton Neuroma?
The exact cause for this condition is unclear but it is commonly associated with the following factors.

  • Biomechanical deformities such as a high-arched foot or a flat foot (link to both). These foot types bring on instability around the toe joints, leading to the development of the condition.

  • Trauma can cause damage to the nerve, resulting in inflammation or swelling of the nerve.

  • Improper footwear that causes the toes to be squeezed together can aggravate the formation of a neuroma. Shoes with a wedge higher than two inches can increase pressure on the forefoot area should be avoided.

  • Repeated stress, common to many occupations can create or aggravate a neuroma.


What can I do myself for relief?

  • Wear shoes with plenty of room for the toes to move, low heels, and laces or buckles that allow for width adjustment.

  • Wear shoes with thick, shock absorbent soles and proper insoles that are designed to keep excessive pressure off of the foot.

  • High heels should be avoided whenever possible because they place strain on the forefoot and can contribute to a number of foot problems.

  • Resting the foot and massaging the affected area can temporarily alleviate neuroma pain. Use an ice pack to help to dull the pain and improve comfort.

  • For simple, undeveloped neuromas, a pair of thick-soled shoes with a wide toe box is often adequate treatment to relieve symptoms.

  • Use over the counter shoe pads. These pads can relieve pressure around the affected area.


What can a podiatrist do for Morton Neuroma?
Treatment options vary with the severity of each neuroma, and identifying the neuroma early in its development is crucial to avoid serious foot complications. The primary goal of most early treatment regimens is to relieve pressure on areas where a neuroma develops. They can involve one or more of the following treatments:

  • Padding and taping - certain padding at the ball of the foot may change the abnormal foot function and relieve the symptoms caused by the neuroma.

  • Orthotic therapy - Orthotics, either over the counter or custom made can be useful in controlling foot function. An orthotic device may reduce symptoms and prevent the worsening of the condition.

  • Footwear - Avoid high heels or tight shoes, and wear wider shoes with lower heels and a soft sole. This enables the bones to spread out and may reduce pressure on the nerve, giving it time to heal. Your podiatrist can recommend suitable footwear to accommodate the orthotics and manage your foot condition.

  • Referral to surgery - when early treatment fail and the neuroma progresses past the threshold for such options, surgery to remove the neuroma may become necessary. The procedure, generally involve the resection of a small portion of the nerve or release the tissue around the nerve can be conducted on an outpatient basis and generally involves a short recovery period.


Several studies have shown that a combination of roomier, more comfortable shoes, nonsteroidal anti-inflammatory medication, custom foot orthoses and cortisone injections provide relief in over 80 percent of people with Morton's Neuroma. Foot pain is never normal, speak to your podiatrist today should you experience any foot pain or discomfort.

 

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