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Morton’s Neuroma — What it Is and How It Can Be Treated

Dr. Benjamin Weaver

Reviewed by
Dr. Benjamin Weaver

A neuroma is a kind of benign nerve tumor, or a growth of nerve tissue. A Morton’s neuroma isn’t really a tumor, exactly, but merely a thickening or inflammation of the tissue surrounding the digital nerve, or of the nerve itself.

This usually occurs between the third and fourth toes (although it may sometimes occur between the second and third toes).

Morton’s neuroma can cause tingling, numbness, and sharp, burning pain in the ball of your foot and in the toes. Women are eight to ten times more likely than men to suffer this condition.

What Are The Symptoms of Morton’s Neuroma?

There are generally no outwardly visible signs of Morton’s neuroma, such as lumps or sores, although sometimes splaying of toes may be noticeable.

In addition to the pain and numbness, many sufferers experience a curious sensation between their toes or in the ball of the foot, as though they were standing on a marble or had a pebble in their shoe, or perhaps a bunched-up fold in their sock.

Other symptoms of Morton’s neuroma:

  • Tingling or numbness between the toes (usually the third and fourth toes) or on the ball of the foot
  • Sharp, stinging, shooting pain in this area (which may worsen when standing or walking)
  • Swelling
  • Cramping

In addition to the symptoms described above, runners may also notice pain when pushing off from the starting block.

How Did I Develop Morton’s Neuroma?

The exact cause of Morton’s neuroma is not entirely clear, but there are a number of factors that seem to contribute to this condition:

  • Tight or ill-fitting footwear
  • Physical deformities such as high arches or flat feet
  • Other foot conditions such as bunions or hammertoes
  • Injury
  • Repeated stress, such as may be associated with certain sports or occupations

Footwear is often suspected as the culprit in cases of Morton’s neuroma, especially tight shoes that squeeze the toes together, or heels higher than two inches—such high heels can put a great deal of pressure on the ball of the foot and the forefoot area.

This is believed to be the reason why women are so much more prone to this condition than men.

High arches, flat feet, and other foot deformities are believed to contribute to Morton’s neuroma by causing instability in the joints of the toes.

Certain injuries can damage the nerve or the tissue surrounding it, causing inflammation and leading to Morton’s neuroma.

What Are The Risk Factors for Morton’s Neuroma?

As noted above, women are far likelier than men to suffer from this condition, especially if they frequently wear high heels. Athletes are also very susceptible, as are people who suffer from the foot problems described above.

What Are The Complications of Morton’s Neuroma?

Left untreated, this condition will continue to become more painful, leading to difficulty walking, and perhaps even driving a car.

How is Morton’s Neuroma Diagnosed?

Early diagnosis can be extremely valuable in the treatment of Morton’s neuroma, and may enable you to avoid surgical treatment. If you are suffering from the symptoms described here, see your podiatrist as soon as possible.

Morton’s neuroma can be diagnosed with ultrasound, but before resorting to these methods your doctor may first take x-rays to rule out bone problems or an injury such a stress fracture.

He or she will also perform a direct physical examination to feel for a palpable mass or a “clicking” when the bones are manipulated. In some cases blood tests may be conducted to rule out other conditions that may cause inflammation, such as arthritis.

How is Morton’s Neuroma Treated?

Conservative treatments may be effective if the condition is diagnosed soon enough. Such treatments may include NSAIDs (non-steroidal anti-inflammatory drugs), cortisone shots, strapping of the foot, physical therapy, and custom-made orthotics.

Another treatment for Morton’s neuroma is ultrasound radiofrequency ablation, which involves the use of high-frequency sound waves to heat the affected nerve.

The heat causes certain proteins to break down, rendering nerve fibers incapable of transmitting pain. Yet another procedure, known as cryotherapy ablation, uses extreme cold to achieve a similar result.

Alcohol injections can also accomplish this objective. After numbing the affected area with a local anesthetic, the doctor uses ultrasound to guide the placement of the needle used for the injection.

Within a half hour after the procedure, the patient will be allowed to walk—carefully. In most cases, patients experience immediate relief and can resume their normal activities the following day.

Follow-up visits are important after alcohol-injection therapy, and additional injections may be necessary if pain persists.

If conservative treatments do not help, however, then surgery may be necessary. This often means a Morton’s neuroma excision, which involves removing the neuroma and part of the nerve. While this will provide relief from the pain, there may be some permanent loss of sensation in the affected area and the adjacent toes.

Can I Prevent Morton’s Neuroma?

The best ways to prevent Morton’s neuroma are to wear  appropriate footwear for athletic activities, not to wear high heels too often, and to avoid wearing heels higher than one and a half inches.

Make sure the toe boxes in your shoes are not uncomfortably tight, and try to wear shoes that provide a little padding for the ball of your foot.

What Is The Overall Prognosis for Morton’s Neuroma?

Conservative, non-surgical treatments for Morton’s neuroma are effective about 75 percent of the time, and surgery has about an 85 percent success rate.

 

Medical References:

    The American Podiatric Medical Association http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=987 National Institutes of Health http://www.nlm.nih.gov/medlineplus/ency/article/007286.htm The American Academy of Orthopaedic Surgeons http://www.orthoinfo.aaos.org/topic.cfm?topic=A00158 The Mayo Clinic http://www.mayoclinic.org/diseases-conditions/mortons-neuroma/basics/definition/con-20026482 The Cleveland Clinic http://my.clevelandclinic.org/health/diseases_conditions/hic_mortons_neuroma

This page was last updated on October 1st, 2015



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