What causes Morton’s neuroma?
What are some causes or factors that can lead to Morton’s neuroma?
The exact cause of Morton’s neuroma is not known. Researchers believe that the persistent pain in the fore-foot is the result of thickening or damage to the interdigital nerve due to chronic physical stress or irritation in the ball of the foot (the planter region) between the metatarsal heads. The irritation can sometime cause fibrosis or swelling of the fibers or tissues in the vicinity of plantar nerve. The irritated fibers can develop a mass or swelling (resembling a benign growth; hence the term neuroma). For a scientific discussion of Morton’s neuroma click here.
Certain predisposing anatomical or environmental factors that may aggravate the risk of Morton’s neuroma are:
- Bursitis: Inflammation of plantar bursa is characterized by presence of a fluid filled sac in the meta-tarsal region, which may produce significant pain and discomfort, and may also lead to Morton’s neuroma in chronic cases.
- Female gender: Clinical data shows that Morton’s neuroma is clearly more common in females due to distinct anatomical characteristics (alignment and foot architecture) and physiological factors (such as choice of high heeled shoes, lifestyle and habits etc.). It has been estimated that as many as 3 out of every 4 females develop Morton’s neuroma that may or may not produce pain or discomfort(1). According to another stud, investigators concluded that Morton’s neuroma is 16-times more common in females as compared to males(2).
Besides above listed risk factors, wrong choice of shoes (ill-fitting, narrow, worn-out shoes) can also aggravate your chances of developing this condition. Likewise, any lifestyle or occupational activity that increases the pressure or tension in the region of the forefoot can also increase your chances of developing Morton’s neuroma.
Certain sports or activities have a higher likelihood of developing Morton’s neuroma include:
- Running regularly
- Ballet dancing
- Military personnel
- Professional athletes
Janet D. Pearl, MD, MSc is the Medical Director of The Center for Morton’s Neuroma and Complete Spine and Pain Care, an interventional and integrated Pain Management program located in Framingham, Massachusetts. Previously, Dr. Pearl was the Co-Director of the Pain Management Center at St. Elizabeth’s Medical Center, where she was also the Director of the Fellowship program. She is the former Director of a satellite pain center of the Brigham and Women’s Hospital, Pain Management Center, located at the HealthSouth Braintree Rehabilitation Hospital. Dr. Pearl held academic appointments at Harvard Medical School and Tufts Medical School. She serves on the Health Care Services Board of the Commonwealth of Massachusetts Department of Industrial Accidents since 2000 as one of its physician representatives and is Chair of the Committee on Pain Management.