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Morton’s Neuroma

Despite the name ‘neuroma’ which depicts a benign nerve tumour, a Morton’s neuroma describes the inflammation of the tissue around a nerve in the foot, causing it to thicken and become painful. It occurs between the long bones of the foot (metatarsals) and most commonly affects a nerve between the third and fourth toes around the ball of the foot.

 

What causes a Morton’s neuroma?

A Morton’s neuroma is often caused by overloading the forefoot, with the sheath around the nerve thickening in response to pressure, injury or irritation of the nerves. Contributing factors can include:

 

  • Shoes that overload or cramp the forefoot such as high heels, pointed shoes and generally tight footwear such as in skiing and rock-climbing
  • Physical activities that place increased pressure on the ball of the foot such as in running and climbing stairs
  • Biomechanical or alignment issues of the feet and legs
  • Foot injury
  • Forefoot deformities such as bunions and hammertoes
  • Female gender

 

 

What are the symptoms?

Symptoms of a Morton’s neuroma include:

  • Pain and tenderness at the neuroma
  • Swelling and redness
  • A palpable mass between the metatarsal bones that is likely not visible when looking at the foot
  • Feeling like you’re walking on a pebble
  • Pain exacerbated by pressure from the sides (squeezing the neuroma)
  • Neural symptoms such as burning, pins and needles, tingling and numbness

 

How is it treated?

Your treatment plan will depend on the severity of your symptoms and your regular activities. Treatment may include:

  • Ice and rest to alleviate painful symptoms, as well as anti-inflammatories where appropriate
  • Orthotics to alleviate pressure away from the neuroma and help correct any biomechanical or alignment issues contributing to its development or persistence
  • Footwear assessment to ensure your shoes are helping and not hindering recovery
  • Soft tissue techniques such as massage or acupuncture
  • Stretching to maintain good range of motion through the foot after the neuroma begins to settle
  • If the neuroma does not improve and continues to cause you pain, surgery may be indicated