What is Morton's Neuroma?
The ailment usually occurs between the third and fourth toes.
If you have pain in the ball of your foot, and sometimes feel as if you're standing or walking on a small stone, you may have a Morton's neuroma. The tissue around the digital nerve that runs into your toes has become thick and is placing pressure on the nerve. Usually this problem develops between the third and fourth toes. In addition to pain, you may also feel a burning sensation in the ball of your foot and toes, or experience tingling or numbness in your toes.
Causes of Morton's neuroma
This foot problem usually develops because of irritation, trauma or too much pressure around the nerve. Women are eight to 10 times more likely to develop a foot neuroma than men, according to the American Academy of Orthopaedic Surgeons. That's because one of the main causes of this painful foot condition is wearing high heels or poorly fitting shoes that put extra pressure on the toes and the ball of the foot.
The condition can also develop as a result of high-impact sports that place a lot of stress on your feet, or from wearing tight-fitting shoes for sports such as rock climbing. If you have other foot problems, such as bunions, hammer toes, flat feet or high arches, you have more risk of developing a neuroma.
Morton's neuroma treatment
When you initially feel foot pain, you can try changing the shoes you wear and avoid activities that stress your feet. But if your pain lasts more than a few days, see your family doctor, especially if you have burning, tingling or numbness. A doctor typically diagnoses Morton's neuroma by examining your foot, but may do imaging tests (X-rays, ultrasound or MRI) to rule out other problems, such as a stress fracture.
Initial treatment is usually conservative. One of the most important steps is to avoid wearing high heels or tight shoes. Wearing wider shoes with lower heels and a soft sole lets the bones spread out and may reduce pressure on the nerve. If you participate in a high-impact activity, such as running, you may need to take a break for few weeks.
Your doctor might also recommend arch supports and foot pads, either over-the-counter products or custom-made orthoses, to help reduce pressure on the nerve. To temporarily relieve pain and swelling, you can take over-the-counter, nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen and naproxen. Another option is ice massage. Fill a paper cup or plastic foam cup with water, freeze it and then roll the frozen cup over the painful area.
If conservative treatment doesn't work, your doctor may suggest one or more injections of a corticosteroid medication to reduce the swelling and inflammation of the nerve. The American Academy of Orthopaedic Surgeons says studies show that more than 80 percent of people with Morton's neuroma get relief by using a combination of roomier, more comfortable shoes, NSAIDs, custom foot orthoses and corticosteroid injections.
If you still have pain, your doctor may suggest neuroma surgery to relieve the pressure on the nerve by cutting nearby structures or surgery to remove the nerve. Removing the nerve is usually successful but can cause permanent numbness in the affected toes. Always discuss the benefits and risks of surgery with your orthopedic surgeon.
