Morton’s Neuroma: Symptoms, Causes, Diagnosis & Treatment

Morton’s neuroma is a benign (non-cancerous) growth of nerve tissue that develops in the foot, usually between the third and fourth toes. It is a common and painful condition.

Morton’s neuroma is also called Morton’s metatarsalgia, Morton’s disease, Morton’s neuralgia, Morton metatarsalgia, Morton nerve entrapment, plantar neuroma, and intermetatarsal neuroma.

The condition is due to a swollen (inflamed) nerve in the ball of the foot, commonly between the base of the third and fourth toes.

This article investigates the symptoms, causes, diagnosis, and treatment of Morton’s neuroma.

Symptoms of Morton’s Neuroma

Typically, there’s no outward sign of this condition, such as a lump. Instead, you may experience the following symptoms:

• A feeling as if you’re standing on a pebble in your shoe
• A burning pain in the ball of your foot that may radiate into your toes
• Tingling or numbness in your toes

Who develops Morton’s Neuroma?

About three people out of four who have Morton’s neuroma are women. It commonly affects people between the ages of 40 and 50 but can occur at any age.

Poorly fitting or constricting shoes can contribute to Morton’s neuroma. It is more common in women who habitually wear high-heeled shoes or in men who are required to wear tight (constrictive) footwear. It may also be more common in ballet dancers and runners. In some people there is no obvious cause.

Causes of Morton’s Neuroma

Anything that causes compression or irritation of the nerve can lead to the development of a neuroma. One of the most common offenders is wearing shoes that have a tapered toe box or high-heeled shoes that cause the toes to be forced into the toe box. People with certain foot deformities—bunions, hammertoes, flatfeet or more flexible feet—are at higher risk for developing a neuroma. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running or court sports. An injury or other type of trauma to the area may also lead to a neuroma.

How to diagnosed Morton’s Neuroma

A doctor can usually identify Morton’s neuroma during a physical exam. He or she will squeeze or press on the bottom of your foot or squeeze your toes together to see if it hurts. Your doctor may also order an X-ray of your foot to make sure nothing else is causing the pain.

Morton’s Neuroma Treatment

Initial therapies are nonsurgical and relatively simple. They can involve one or more of the following treatments:

• Changes in footwear. Avoid high heels or tight shoes, and wear wider shoes with lower heels and a soft sole. This enables the bones to spread out and may reduce pressure on the nerve, giving it time to heal.
• Orthoses. Custom shoe inserts and pads also help relieve irritation by lifting and separating the bones, reducing the pressure on the nerve.
• Injection. One or more injections of a corticosteroid medication can reduce the swelling and inflammation of the nerve, bringing some relief.

Several studies have shown that a combination of roomier, more comfortable shoes, nonsteroidal anti-inflammatory medication, custom foot orthoses and cortisone injections provide relief in over 80 percent of people with Morton’s Neuroma. If conservative treatment does not relieve your symptoms, your orthopaedic surgeon may discuss surgical treatment options with you. Surgery can resect a small portion of the nerve or release the tissue around the nerve, and generally involves a short recovery period.