What Is Morton's Neuroma?
Morton’s neuroma, also called intermetatarsal neuroma, results from the thickening of tissue in your toe. This tissue is next to a nerve. So the pressure against the nerve irritates it and causes pain.
You might be walking along and feel a pain near the ball of your foot, like there’s a pebble inside your shoe. The pain usually crops up between your third and fourth toes. (That’s counting the big toe as the first.)
Women are more likely than men to get Morton’s neuroma. Why? You can probably guess: High-heeled shoes are often to blame, because they put pressure on the feet. The cure may be as simple as switching to shoes with lower heels.
Morton's neuroma is common, affecting an estimated 1 in every 3 people during their lifetime.
Morton’s Neuroma Symptoms
What does Morton’s neuroma look like?
Morton’s neuroma has no visible sign, such as a lump. So you have to go by what you feel.
What does Morton’s neuroma feel like?
The first sign may be a tingling between your toes. After that:
- The tingling may get stronger as time goes on.
- You may feel sharp, shooting pains around the ball or your foot or the base of your toes. This pain may also get worse over time.
- Your foot may feel like there’s a pebble in your shoe or a sock is bunched up underneath it. Your toes might burn or feel numb.
- The discomfort may get worse when you’re walking or wearing shoes that squeeze your feet. It might go away when you take off your shoes, rest, or rub our feet.
- The pain tends to ease off at night.
Morton’s Neuroma Causes
Doctors don’t know exactly what causes Morton’s neuroma. They think that it may happen when the nerve that leads to your toe gets irritated, mashed, stretched, or injured.
Several things can make it likelier to happen. They include:
Shoes: High heels can put pressure on your toes or the balls of your feet. Shoes that are tight or don’t fit right also can do it.
Sports: High-impact activities such as running or tennis can cause stress on the balls of the feet. Snow skiing and rock climbing, which involve tight shoes, can put pressure on your toes.
Staying on your feet: A job in which you need to be on your feet all day can raise your risk of having Morton's neuroma.
Your feet themselves: Flat feet, high arches, bunions, misshapen toes (“hammertoes”), or other foot conditions can make you more likely to get the condition.
When to Call a Doctor
If pain lasts longer than a few days, don’t ignore it. Switch to shoes that are easier on your feet. Don’t exercise as hard for a while, or do something (like swimming) that doesn’t pound on your feet.
If you take these steps and your feet still hurt after a couple of weeks, see your doctor. Finding the problem fast can make it much easier to deal with. Left untreated, a Morton’s neuroma can grow bigger and even lead to permanent nerve damage.
People with diabetes should see a doctor any time they have foot problems.
What kind of doctor treats Morton’s neuroma?
Your regular doctor can examine your feet to see if you have Morton's neuroma. If you need treatment, they can refer you to a foot specialist called a podiatrist. If your condition requires surgery, you'll see an orthopedic surgeon.
Morton’s Neuroma Diagnosis
To tell whether you have Morton’s neuroma, your doctor may only need to ask you about your symptoms and examine your foot. But you may need further tests to make sure.
To diagnose you, your doctor can use:
Symptom history. Your doctor will ask about the pain you’re having, when it started, the kinds of shoes you wear, and your work and other activities.
Physical exam. Your doctor will probably first press on your foot to check for a tender spot. If you feel a sort of click between the toes, that can also be a sign of Morton’s neuroma.
Range of motion test. Your doctor will move your foot and toe around to see if the cause of your pain could be arthritis or joint inflammation.
X-ray. An X-ray might help your doctor rule out other potential problems, such as a fracture.
Ultrasound. This test uses sound waves to create images. It's a good way to spot Morton’s neuroma and other conditions that involve soft tissue.
MRI. Magnetic resonance imaging uses radio waves and a magnetic field to look at your soft tissues. Doctors don’t usually use MRIs for diagnosing Morton’s neuroma, because it’s an expensive test.
Morton’s Neuroma Treatment
Treatment for Morton's neuroma depends on how bad your symptoms are.
Your doctor will likely first recommend that you avoid high heels and tight shoes, making sure your footwear leaves plenty of room for your toes. You'll also need to rest your feet by avoiding high-impact activities like running and jumping until your symptoms improve. They may also suggest using ice packs or doing ice massage at the site of your pain to ease discomfort. For an ice massage, simply roll the painful foot over a paper or foam cup full of frozen water.
If you weigh more than is healthy for you, losing some of the extra pounds may help, too.
Other treatments include:
Inserts for Morton’s neuroma
Arch supports and pads that fit inside your shoe reduce the pressure on your foot. Drugstores sell some kinds over the counter, which means that you don’t need a prescription. But your doctor may prescribe a custom-made one that has been molded to fit your foot exactly.
Morton’s neuroma pain relief
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can reduce swelling and pain. Ask your doctor or pharmacist about which pain reliever and which dosage might be right for you. Never take NSAIDs more than 10 days in a row without your doctor's OK.
Injections for Morton’s neuroma
Your doctor can give you a shot of local anesthetic in your toe to numb the area. They can also give you steroid injections to ease the irritation of the nerve.
Physical therapy for Morton’s neuroma
In some cases cases, your doctor might recommend physical therapy for Morton's neuroma. A physical therapist might assess your footwear, use massage or moist heat to ease pain, and show you exercises to help stretch and strengthen your feet and ankles. You might also need physical therapy after having surgery for Morton's neuroma.
These treatments work for most people, though It might take six months or longer to get relief from your symptoms. And symptoms of Morton’s neuroma often come back. If these conservative treatments don't relieve your symptoms and it's very painful for you to walk, your doctor might move on to:
Cold therapy for Morton's neuroma
Also called cryogenic neuroablation, this procedure involves applying extremely low temperatures to the irritated nerve to kill some of the cells there. This makes Morton’s neuroma less likely to come back.
Radiofrequency ablation
This procedure uses heat from an electrical current to destroy some of the nerve cells in the affected areas. That keeps them from transmitting pain signals to your brain.
Morton’s neuroma surgery
Decompression surgery involves cutting areas inside your foot that are near the affected area, such as a ligament. This may reduce the pressure on the nerve. Another surgical option is neurectomy, which removes the painful nerve.
Morton’s Neuroma Prevention
You can't always prevent Morton's neuroma. But some simple precautions will help you keep problems away. They include:
- Don’t wear high heels or tight shoes for long periods.
- Buy shoes that are wide enough at the toe that they don’t squeeze.
- Choose athletic shoes or socks with enough padding in the soles to cushion your feet when you run or play sports.
- Talk to your doctor about adding an orthotic insert to your shoe. They can help correct imbalances that might contribute to Morton’s neuroma. You can get some types over the counter in drugstores.
- Keep up with any exercises your physical therapist or doctor recommends to help strengthen your foot.
- Reach and maintain a weight that's healthy for you.
Morton’s Neuroma Outlook
For most people, changes in footwear and activity, shoe inserts, and/or shots are enough to bring long-lasting relief from symptoms of Morton's neuroma. But if you’ve tried all these things and still don’t get relief, your doctor might suggest surgery. For people who have it for this condition, it helps about 75%-85% of the time.
Takeaways
Morton’s neuroma is an inflammation of a nerve in your foot that results from the thickening of tissue in your toe. It's often caused by high-heeled or tight-fitting shoes, or by physical activities that put lots of pressure on your feet. It can cause pain and tingling in your foot, and a feeling like there's a pebble in your shoe. Most people who get it are able to get relief from their symptoms with simple treatments. But in some cases, you may need surgery. See your doctor if you have foot pain that's not getting better. Prompt treatment can help you avoid permanent nerve damage.
Morton’s Neuroma FAQs
Can Morton's neuroma be cured?
Morton's neuromas won't go away on their own, although treatment and lifestyle modifications ease symptoms for most people. The condition tends to come and go. It can sometimes come back even if you have surgery, though this isn't common
What makes Morton's neuroma worse?
Things that can make Morton's neuroma worse include:
- Wearing ill-fitting or high-heeled shoes
- Doing sports or other activities that put stress on your feet, such as jumping and running
- Foot injuries and problems like high arches, bunions, and hammertoes
- Carrying extra body weight
