What is Morton’s neuroma?
Morton’s neuroma (also known as Morton’s metatarsalgia, Morton’s neuralgia, plantar neuroma or intermetatarsal neuroma) is a thickening of the nerve that supplies sensation to the area between the toes. It is not cancerous but is often very painful.
What causes Morton’s neuroma?
It is caused by the squeezing and irritation of a small nerve called the common plantar digital nerve which provides the sensation to the webspace between the toes. This nerve runs very close to an important supporting ligament of the forefoot, the transverse intermetatarsal ligament which runs across the forefoot bones.
As the nerve runs under the transverse intermetatarsal ligament in the ball of the foot, it becomes trapped and squeezed against the ligament. The continual pressure on the nerve causes the irritation reaction to reoccur becoming chronic resulting in fibrosis within the nerve and thickening of the nerve. Unfortunately, this thickened, fibrotic nerve further compresses the nerve cells causing greater pain. The pain can become so intense that it prevents weight bearing and walking.
What are the symptoms?
Symptoms are typically on one side of the foot, usually between the third and fourth toes but the pain can extend outwards or even involve the whole side of the foot. You will not likely feel a lump in your foot, because a neuroma is generally small. You may feel a burning pain in your forefoot, and this pain can extend into the toes. The pain is generally worse when wearing shoes or with activity, and can create the feeling of a pebble in the shoe. In addition, you may feel numbness and tingling in the toes as the condition affects the sensory aspects of the nerves in the foot.
The episodes of pain can be intermittent. You may experience flare ups such as two attacks in a week, but then have no symptoms for over a year. However, the attacks tend to become more frequent as time progresses. Rarely, a foot may contain two separate Morton’s neuromas.
Who Gets Morton’s neuroma And Why?
Morton’s neuroma is a common condition of the foot that affects women more often than men, with a female-to-male ratio of 4:1. They tend to occur in ages 50 – 60 although Morton’s neuroma can occur at any age in which a great deal of walking or exercising occurs.
Certain risk factors make Morton’s neuroma more likely. For instance, wearing narrow or high-heeled shoes is a well-known cause of this condition, and an important part of treatment focuses on wearing shoes that allow more space for the foot and toes.
High impact activities, such as running or jogging, can put pressure on the ligament and cause thickening of the nerve. Sports are another common cause of Morton’s neuroma. Certain sports that require tight fitting shoes, such as skiing, are more likely to cause Morton’s neuroma.
Finally, deformities of the feet, such as hammer toes, bunions, and flat feet, can cause the ligament to press on the nerve. In some cases, wearing supportive shoes can help when this is the cause of the condition, but more aggressive treatments may be necessary to correct the foot deformity.
For an in-depth discussion of Morton’s neuroma see A Scientific Discussion of Morton’s neuroma.
We offer a number of procedures to treat Morton’s neuroma without surgery. To see the treatments we offer for Morton’s neuroma click here.