A Morton’s neuroma is one of the most common problems treated by podiatrists today.
A Morton’s neuroma is an irritated swollen nerve in the forefoot classically described as a pain in the ball of the foot located between the base of the 3rd and 4th toes. The involved nerve becomes irritated by these adjacent metatarsal heads causing the painful neuroma to develop. The metatarsal heads are located in the ball of the foot. This area is already subjected to considerable pressure from shoes and walking.
A Morton’s neuroma is more common in females than males. High-heeled shoes with cramped pointed toes cause additional pressure and irritation on nerves in the forefoot. Walking in ballet flats or barefoot can worsen the symptoms.
Individual complaints for a neuroma vary. Frequently, a burning sensation is experienced in the ball of the foot. A sharp pain is sometimes experienced between the bones (metatarsal heads) at the base of the toes. The pain and sometimes a “feeling of numbness” may involve the corresponding toes that the nerve supplies.
Walking in certain shoes can aggravate the pain. Often a patient will state there is relief after removing their shoes. Many patients will massage their foot after removing their shoes. A patient describes a sensation of “walking on a pebble” or a “wad of sock” because the swollen nerve is felt under the ball of the foot.
A diagnosis of neuroma is based on the symptoms described by the patient and a good clinical examination. Tenderness is reproduced when specific areas of the foot are touched. Sometimes you can feel this “mass” or neuroma. The clinical exam will rule out other disorders which may present with similar symptoms.
Conservative treatment begins with anti-inflammatory medication, custom made orthotics, injections and changing the shoe types. In chronic cases, surgical excision of the involved nerve provides the best relief from the painful condition. Early diagnosis and treatment of the problem will increase the success of conservative care.