Morton’s neuroma is a small lump that forms around the plantar nerve, usually between the 2nd and 3rd toes or the 3rd and 4th toes. It can cause pain while walking or running, along with numbness on the top of the foot and in the toes.
This condition is more common in people who frequently wear high heels with narrow toe boxes. It can also occur in people who are physically active, especially runners, because repeated pressure on the same area of the foot can cause small injuries over time.
It is important to see a doctor, such as a podiatrist or orthopedic foot specialist, if you have symptoms of Morton’s neuroma. Treatment may include measures such as medications, orthotics and physical therapy, and in more severe cases, injections or surgery.
Main symptoms
The main symptoms of Morton’s neuroma are:
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Severe pain in the ball of the foot, often with a burning sensation, that gets worse when going up or down stairs and improves when the area is massaged.
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Numbness in the ball of the foot and in the toes.
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A shock-like sensation between the 2nd and 3rd toes or between the 3rd and 4th toes.
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Muscle tightening.
Symptoms of Morton’s neuroma usually occur when the toes are overly extended, which increases pressure on the affected nerve and compresses the neuroma in that area.
Confirming a diagnosis
Morton’s neuroma is diagnosed by a podiatrist or orthopedic foot specialist based on your symptoms and a physical examination of the foot, including checking for tenderness or a lump between the toes.
Imaging tests such as ultrasound or MRI may also be done to confirm the neuroma and rule out other foot problems, such as tarsal tunnel syndrome, peripheral neuritis, neuropathy, and rheumatoid arthritis.
These imaging tests are also important for checking how severe the condition is, which helps guide the most appropriate treatment, although according to the American Academy of Orthopaedic Surgeons, advanced imaging such as MRI is only needed in certain cases.
Main causes
The main cause of Morton’s neuroma is wearing high heels with narrow toe boxes, which is why this condition is more commonly identified in women.
This happens because high heels shift pressure away from the heel and onto the front of the foot, which can contribute to callus formation.
According to the NHS, Morton’s neuroma is often associated with wearing tight, pointy, or high-heeled shoes, as well as running and other activities that place repeated pressure on the feet.
It can also develop in people who wear unsuitable shoes for running outdoors or on a treadmill, since repeated microtrauma may lead to inflammation and neuroma formation.
Treatment options
Morton’s neuroma treatment should be guided by a podiatrist or an orthopedic specialist and may include:
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Wearing comfortable shoes for daily activities and exercise.
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Using special insoles, depending on the type of shoe, to better support the foot and keep the toes separated.
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Getting injections in the area of the neuroma.
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Using medications to relieve local pain and discomfort.
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Attending physical therapy sessions to stretch the plantar fascia and toes, which may include the use of equipment such as ultrasound, microcurrent therapy, or laser therapy.
If symptoms do not improve with medications, injections and/or physical therapy, surgery to remove the neuroma may be recommended.