Morton’s neuroma (Intermetatarsal Neuroma) is a thickening of the tissue that surrounds the digital nerve that leads from the ball of the foot between the third and fourth toes. The condition results from compression and irritation of the nerve and, left untreated, leads to permanent nerve damage. The incidence of Morton’s neuroma is as much as 10 times greater in women as in men.
CAUSES OF MORTON’S NEUROMA
The most common cause of Morton’s neuroma is wearing tight, narrow shoes that have a pointy toe box or high heeled shoes that cause the toes to be forced forward into the toe box. Certain foot deformities such as bunions, hammertoes and flatfeet carry a greater risk for nerve compression. Activities that involve repetitive irritation of the ball of the foot, such as running, basketball and tennis are also risk factors. A neuroma can result from traumatic injury to the area.
Symptoms of a neuroma begin gradually as an occasional tingling or numbness when wearing shoes with a tapered toe or while performing certain activities. In the beginning, the discomfort may go away once
the shoe is removed and the foot is massaged and rested. Over time, the symptoms progressively worsen and may persist for several days or
weeks, intensifying as the neuroma enlarges and changes the nerve permanently. \
Early diagnosis of Morton’s neuroma greatly lessens the need for more invasive treatments and can help you avoid surgery. Consult with a foot and ankle surgeon if you are experiencing any of the following symptoms.
• Tingling, numbness or an unpleasant feeling in the toes.
• Burning pain in the ball of the foot that may radiate into the toes and intensifies with activity.
• The feeling that something is inside the ball of the foot.
• The feeling that a pebble or marble is in the shoe or a sock is bunched up.
Treatment plans vary according to the severity of the condition. An estimated 80 percent of people with Morton’s neuroma are successfully treated non-operatively. Surgery may be recommended for patients who do not experience relief from nonsurgical treatments. Mild to moderate neuromas are usually treated with the following options:
• Icing the affected area to reduce swelling.
• Footwear modifications.
• Offloading pads or shoe inserts that ease the pressure on the nerve when walking.
• Custom orthotic devices can also provide the support to reduce pressure and compression on the nerve.
• Activity modification to avoid repeatedly aggravating the nerve.
• Oral non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen may reduce pain and swelling.
• Injections of cortisone, local anesthetics or other agents may be needed in some cases.
• Minor surgery to release nerve pressure if pain persists despite above treatments.