Morton’s Neuroma: Symptoms, Causes, Treatment

What are the symptoms of Morton’s neuroma?

Morton’s neuroma, also known as Morton’s metatarsalgia or interdigital neuroma, is a condition characterized by the compression and irritation of the nerves between the toes, typically between the third and fourth toes. The symptoms of Morton’s neuroma can vary in severity and may include:

1. Shooting pain: Pain that shoots from the affected toe to other parts of the foot, such as the heel or ankle.
2. Numbness: Numbness or tingling sensations in the affected toe or foot.
3. Burning sensation: A burning sensation on the bottom of the foot, especially on the ball of the foot.
4. Sharp pain: Sharp, stabbing pain on the bottom of the foot or on the sides of the toes.
5. Cramping: Cramping in the feet or toes, especially at night.
6. Weakness: Weakness in the toes, which can cause difficulty walking or standing.
7. Bruising: Bruising or discoloration under the skin of the affected toe or foot.
8. Swelling: Swelling around the affected toe or foot.
9. Paresthesia: Paresthesia, or abnormal sensations such as numbness, tingling, or prickling, in the affected toe or foot.

The symptoms of Morton’s neuroma can worsen with:

• Wearing high heels
• Wearing shoes that are too tight or constrictive
• Running or jumping
• Standing for long periods
• Prolonged pressure on the ball of the foot

If left untreated, Morton’s neuroma can lead to chronic pain and discomfort in the affected foot and may eventually cause permanent nerve damage. It is essential to seek medical attention if you are experiencing symptoms of Morton’s neuroma to determine the best course of treatment.

What are the causes of Morton’s neuroma?

Morton’s neuroma, also known as Morton’s metatarsalgia or interdigital neuroma, is a condition characterized by the compression and irritation of the nerves between the toes, typically between the third and fourth toes. The causes of Morton’s neuroma can be attributed to a combination of factors, including:

1. Pressure: Prolonged pressure on the nerves between the toes can cause irritation and inflammation, leading to the development of a neuroma.
2. Abnormal toe alignment: Abnormal alignment of the toes, such as hammertoes or claw toes, can cause pressure on the nerves and lead to the development of a neuroma.
3. Foot mechanics: Abnormal foot mechanics, such as overpronation or supination, can cause excessive pressure on the nerves and lead to the development of a neuroma.
4. Trauma: Trauma to the foot, such as stubbing or dropping heavy objects on the foot, can cause nerve damage and lead to the development of a neuroma.
5. Poor footwear: Wearing shoes that are too tight, poorly fitting, or with high heels can cause pressure on the nerves and contribute to the development of a neuroma.
6. Age: The risk of developing Morton’s neuroma increases with age, particularly in people over 40 years old.
7. Genetics: A family history of Morton’s neuroma may increase an individual’s risk of developing the condition.
8. Occupational factors: People who engage in activities that involve repetitive pressure on the feet, such as dancing or running, may be more likely to develop Morton’s neuroma.

It’s essential to note that Morton’s neuroma is not caused by a specific injury or trauma, but rather it is a chronic condition that develops over time due to repeated pressure and irritation on the nerves. Early detection and treatment can help alleviate symptoms and prevent further progression of the condition.

How is the diagnosis of Morton’s neuroma made?

The diagnosis of Morton’s neuroma, also known as Morton’s metatarsalgia or interdigital neuroma, is typically made through a combination of physical examination, medical history, and diagnostic imaging tests. The following steps are often involved in the diagnostic process:

1. Physical examination: A thorough physical examination is performed to evaluate the foot and toes for signs of pressure, inflammation, and nerve damage. The healthcare provider may perform the following tests:
   • Palpation: The healthcare provider will gently press on the affected area to identify areas of tenderness and swelling.
   • Percussion: The healthcare provider will tap on the affected area to elicit pain or discomfort.
   • Compression: The healthcare provider will apply pressure to the affected area to see if it reproduces the symptoms.
2. Medical history: The healthcare provider will take a detailed medical history to gather information about the patient’s symptoms, including:
   • When the symptoms started
   • What activities exacerbate or relieve the symptoms
   • Any previous injuries or traumas
   • Any previous treatments or surgeries
3. Diagnostic imaging: Diagnostic imaging tests may be ordered to confirm the diagnosis and rule out other conditions:
   • X-rays: X-rays can help identify bone deformities or fractures that may be contributing to the symptoms.
   • Ultrasound: Ultrasound can help visualize the nerves and soft tissues in the foot and identify any signs of compression or irritation.
   • MRI: MRI can provide detailed images of the nerves and soft tissues in the foot, which can help confirm the diagnosis.
4. Electromyography (EMG): EMG may be performed to assess nerve function and rule out other conditions that may be causing similar symptoms.

The combination of physical examination, medical history, and diagnostic imaging tests can help healthcare providers diagnose Morton’s neuroma with a high degree of accuracy. However, in some cases, a biopsy may be necessary to confirm the diagnosis.

What is the treatment for Morton’s neuroma?

The treatment for Morton’s neuroma, also known as Morton’s metatarsalgia or interdigital neuroma, typically involves a combination of conservative and surgical options. The goal of treatment is to reduce pain, alleviate pressure on the nerves, and improve foot function.

Conservative treatments:

1. Orthotics: Custom orthotics or shoe inserts can help redistribute pressure and alleviate pressure on the affected nerve.
2. Padding: Padding the ball of the foot with gel or foam can help cushion the area and reduce pressure.
3. Footwear modifications: Wearing shoes with a wide toe box, soft materials, and a low heel-to-toe drop can help reduce pressure on the affected nerve.
4. Corticosteroid injections: Injecting corticosteroids into the affected area can help reduce inflammation and relieve pain.
5. Physical therapy: Physical therapy exercises can help improve foot mechanics, reduce pressure on the affected nerve, and strengthen surrounding muscles.
6. Acupuncture: Acupuncture may help reduce pain and inflammation by stimulating specific points on the foot.

Surgical treatments:

1. Neurectomy: Removing a portion of the affected nerve can help relieve pain and pressure.
2. Nerve release: Cutting or releasing the compressed nerve can help relieve pressure and pain.
3. Bone resection: Removing a small portion of bone to alleviate pressure on the nerve.
4. Reconstructive surgery: Reconstructive surgery may be necessary in cases where the nerve is severely compressed or damaged.

Other treatments:

1. Cryotherapy: Freezing the affected area to numb the pain.
2. Radiofrequency ablation: Using heat or cold to destroy nerve fibers that are responsible for pain transmission.
3. Physical therapy modalities: Modalities such as ultrasound, heat, or cold therapy may be used to relieve pain and inflammation.

It’s essential to work with a healthcare provider to determine the best course of treatment for Morton’s neuroma based on the severity of symptoms and individual needs.