Morton’s neuroma, also called an interdigital neuroma, is a condition in which the nerve between the metatarsals gets irritated or injured due to squeezing and pinching. This leads to pain that many people say feels like stepping on a pebble when they walk. The nerve gets pinched most often between the third and fourth metatarsals, and the pain can radiate into the 3rd and 4th toes.
This extremely common condition affects about one in three people at some point in their lives, according to the Cleveland Clinic. If you have symptoms of Morton’s neuroma, your physician may recommend nonsurgical treatment options to provide relief.
A diagnosis of Morton’s neuroma is not any type of tumor or anything cancerous. The “pebble” that you may feel occurs because of the pinching of the nerve between the metatarsals, which creates pain on the bottom of the foot. Morton’s neuromas can cause symptoms such as:
However, some people develop this condition but remain symptom-free.
Morton’s neuroma can result from excessive pressure, trauma, or irritation, leading to scar tissue that wraps around the actual nerve between the metatarsals, causing uncomfortable nerve compression.
This condition usually arises in adults aged 30 to 60 but can affect people of any age. Morton’s Neuroma also occurs more frequently in women than men, as women’s shoes are tighter and more narrow.
The Mayo Clinic reports that wearing high heels or shoes with a tight toe box can increase the risk of Morton’s neuroma. It’s common in people who play sports involving the ball of the foot, such as racquetball, tennis, rock climbing, skiing, and running. It also tends to affect individuals who have a history of foot injuries, hammertoe, bunions, high arches, or flat feet.
It’s important to see a foot doctor if you have symptoms of Morton’s neuroma. Left untreated, this condition can cause chronic pain and permanent nerve damage. Diagnosis typically requires a medical history and physical exam. The doctor will check your foot’s range of motion and may squeeze your toes to listen for a small click that’s often present in people who have Morton’s neuroma. Your doctor may also use X-ray, MRI, or ultrasound imaging to rule out other conditions that cause similar symptoms, such as arthritis.
Morton’s neuroma usually gets better with conservative treatments. You should get new shoes that are larger and wider, minimize ballistic or impact activities, and take a break from activities like dancing or running that irritate the foot until the pain goes away. Seek medical treatment if you rest your foot or take over-the-counter pain medications for longer than a week without relief.
Your foot doctor may recommend other nonsurgical treatment options for this condition.
Your doctor can prescribe customized inserts to place inside your shoes. These orthotics are molded to the exact anatomy of your feet. These devices transfer pressure away from the ball of the foot in the affected area. You may also find relief by massage therapy, which we offer at our office, icing the affected area, and getting wider shoes with arch and metatarsal padding.
Your doctor may also recommend physical therapy. A therapist will teach you exercises that can help relieve the discomfort in your foot and improve mobility.
Replace tight shoes or high heels with correctly fitting, supportive shoes. Look for pairs with heels less than 2 inches and a wide rather than tapered toe box. When you exercise, make sure you wear athletic sneakers with padding and thick, comfortable socks. If you’re overweight, losing weight can also reduce the nerve compression causing your symptoms. Eating a nutritious diet and having an exercise plan helps keep your feet (and other bones and joints) healthy.
Steroid injections can often shrink the size of the thickened toe tissue, resolving nerve compression and pain. About half of people with Morton’s neuroma who try steroid injections experience relief.
Sclerosing injections relieve nerve pain by destroying the affected nerve tissue. Patients who have had this treatment for Morton’s neuroma remained free of symptoms after five years.
In cases where conservative treatments fail to relieve the pain, Morton’s neuroma may require surgical correction. Our surgeons can detach soft tissue in the affected area to reduce nerve compression. They perform a neurectomy to remove the inflamed nerve completely. Surgical treatments for Morton’s neuroma have a success rate of up to 95%, but about 5% to 20% of these individuals have recurrent Morton’s neuroma in the future.
You should contact the doctors at Gurnee Podiatry & Sports Medicine Assoc. anytime you have foot pain that lasts longer than a few days and doesn’t resolve with rest, ice, compression, and elevation (the RICE method). At Gurnee Podiatry & Sports Medicine Associates, we offer patient-centered foot and ankle care for a wide range of concerns, including Morton’s neuroma. Reach out today to schedule your appointment.