Morton Neuroma Foot: Causes, Symptoms, and Treatment

Have you ever felt a sharp, burning pain in the ball of your foot? It's like stepping on a marble. This might be Morton's neuroma, affecting up to 1 in 3 women and 1 in 15 men.

It's a painful condition that usually happens between the third and fourth toes, causing a lot of pain.

It's important for anyone, especially runners, fashion lovers of high heels, or those with foot issues like bunions or flat feet. Let's explore this common but often misunderstood condition together.

Morton's neuroma is a condition that affects the nerves in the forefoot. It causes pain, numbness, and tingling sensations. It's not a tumor but a thickening of tissue around the digital nerve leading to the toes. This nerve compression can make it hard to do certain activities.

The term "neuroma" means a benign growth of nervous tissue. In Morton's neuroma, the tissue around the digital nerve gets thick. This leads to nerve compression and irritation. It mostly affects middle-aged women, with a 9:1 female-to-male ratio. Symptoms include burning pain, numbness, and tingling in the affected toes, which gets worse with walking or standing.

The human forefoot has 14 toe bones and 5 long bones. The spaces between these bones, called web spaces, are where Morton's neuroma often develops. The third web space, between the third and fourth metatarsals, is the most common spot for this condition. Sometimes, nerve pain can also happen in the second web space, between the second and third toes.

This condition usually affects only one foot but can happen in both. The repeated stress and pressure on the metatarsals can make the nerve inflamed and thick. Wearing shoes that are too tight can make it worse by compressing the forefoot and irritating the nerve.

The exact cause of Morton's neuroma is still a mystery. But, it's thought to be due to nerve entrapment. This means the nerves in the foot get squeezed or compressed. This can happen between the toes, leading to swelling and abnormal tissue around the nerve.

The way your foot is built and moves is key to getting Morton's neuroma. It often hits the nerve between the 3rd and 4th toes. This nerve gets pinched and irritated, causing problems.

Foot issues like bunions or hammertoes can mess with how your foot moves. This makes it more likely to get a neuroma.

Here are some things that make you more likely to get Morton's neuroma:

• Gender: Women are much more likely to get it than men, especially those in their middle years.
• Footwear: Shoes that squeeze your toes or high heels can make it worse by putting too much pressure on the foot.
• Foot deformities: Bunions or hammertoes can change how your foot lines up, making nerve problems more likely.
• Repetitive trauma: Doing activities that hurt the ball of your foot a lot, like running, can lead to a neuroma.

Knowing what causes Morton's neuroma helps you avoid it. Fixing foot problems, picking the right shoes, and changing your activities can lower your risk. This can help prevent nerve problems and neuromas.

Morton's neuroma symptoms get worse when you walk, run, or stand a lot. The pain can feel sharp and spread from the foot to the toes.

People with Morton's neuroma might feel like they're walking on a pebble or a bunched-up sock. This happens because the nerve tissue gets bigger and presses on the foot's structures. Wearing tight shoes or high heels makes it worse.

Getting an accurate diagnosis of Morton's neuroma is key to finding the right treatment. Doctors use both physical checks and imaging tests to confirm the neuroma and rule out other foot pain causes.

During the physical check, the doctor looks at the foot and ankle for signs of Morton's neuroma. They might notice:

• Visible skin issues
• Deformities in the toes and foot
• Pain when pressing between the toes
• How well the toe joints move

They might also check for a "Mulder's click," a clicking feeling between the toes when the foot is squeezed. This sign is often seen with Morton's neuroma, found in about 83% of cases, as reported in the Journal of Foot and Ankle Surgery in 2015.

People with Morton's neuroma have many non-surgical ways to ease their symptoms. These methods are often the first choice because they can lessen pain and improve how the foot works without surgery. Morton's neuroma affects about one in three people at some point, with women more likely to get it due to wearing high heels or tight shoes.

Changing your shoes is key to handling Morton's neuroma. It's best to skip high heels and shoes that squeeze the toes. Instead, wear shoes with a roomy toe box and a soft sole. Using metatarsal pads under the foot can also ease the pain by spreading out the pressure.

Trying adaptive footwear is a quick way to improve your comfort levels without sacrificing mobility.

After surgery for Morton's neuroma, recovery is usually quick. Patients can walk on the affected foot while wearing a stiff-soled shoe. But, if the surgery was on the foot's bottom, they should put all their weight on the heel to protect the surgery site.

It's important to keep the surgical wounds dry and avoid soaking the foot in water until fully healed. This usually takes about 2 to 3 weeks after surgery. During this time, it's best to avoid hard activities that could stress the healing foot.

As healing goes on, patients can slowly get back to their usual activities. We let our patients switch to regular shoes about 4 weeks after surgery. It's key to follow the post-op instructions from the surgical team for proper healing and to lower the chance of problems.

To help with recovery and prevent the neuroma from coming back, we suggest:

• Wear supportive, well-fitting shoes with enough room for your toes
• Use orthotic inserts or metatarsal pads to spread out the pressure on your foot
• Do foot and toe stretches and exercises as your healthcare provider tells you
• Slowly increase your activity levels and avoid high-impact exercises until fully healed

By following these tips and working with your podiatrist or orthopedic specialist, you can have a smooth recovery and a good outcome after surgery for Morton's neuroma.

Morton's neuroma can be painful and disrupt your life. But, there are steps to lower your risk. By choosing the right shoes and doing foot exercises, you can keep your feet healthy. This helps prevent Morton's neuroma.

Choosing the right shoes is key to preventing Morton's neuroma. Shoes with a wide toe box let your toes spread out naturally. This reduces pressure on the nerves in the ball of the foot.

Avoid high heels and tight, narrow shoes. They can compress the toes and increase the risk of Morton's neuroma. Switching to lower heeled shoes with wide toe boxes can bring relief. Always look for comfort and proper shoe fit when shopping for shoes.

Wearing the right shoes is just part of the solution. Doing foot exercises and stretches can also help. These exercises improve flexibility, strengthen foot muscles, and reduce forefoot pressure.

• Toe spreads: Spread your toes apart as wide as possible, hold for 5 seconds, and repeat 10 times.
• Toe curls: Place a towel on the floor and use your toes to scrunch it up. Repeat 10 times.
• Calf stretches: Step forward with one leg, keeping the back leg straight and the heel on the ground. Lean forward until you feel a stretch in your calf. Hold for 15-30 seconds and repeat on the other leg.

If you have foot deformities like bunions, hammertoes, high arches, or flat feet, you're more likely to get Morton's neuroma. It's crucial to pick the right shoes and do regular foot exercises. These steps can help keep your feet healthy and lower your risk of this painful condition.

If you have foot pain that doesn't go away after a few days, don't ignore it. A burning feeling in the ball of your foot or numbness in your toes means it's time to see a doctor. These signs could mean you have Morton's neuroma or another foot issue that needs help.

Seeing a doctor early can stop Morton's neuroma from getting worse and help you feel better. Many people find relief by changing their shoes, using special shoe inserts, or getting injections. In fact, 41% got better just by changing their footwear, and 47% found relief with injections.

If these treatments don't work, surgery might be needed. Surgery helps 75 to 85% of people feel better, and 96% see some improvement. Even though long-term studies are limited, they show surgery is very effective.

Don't ignore foot pain, burning, or numbness in your toes. Make an appointment with an orthopedic surgeon for a proper check-up and treatment plan. Getting help for Morton's neuroma early can ease your symptoms and stop them from getting worse.