What is a Morton's neuroma and what can be done about it?

A common reason for shooting pains in the foot is what is called a Morton's Neuroma which can be painful and often debilitating disorder involving the small nerves in the forefoot. The neuroma is a non-cancerous growth of nerve tissue that develops most often between the third and fourth toes, although it can occur between other toes as well. This condition is characterized by the thickening of the tissue surrounding one of the nerves leading to the toes, often causing pain, discomfort, and a burning sensation in the ball of the foot. The pain will typically intensify while walking, wearing tight shoes, or applying pressure on the affected area.

The exact cause of Morton's Neuroma is not fully understood, but several factors are believed to contribute to its development. One of the primary causes is the compression or irritation of the interdigital nerve due to repeated trauma or pressure from two adjacent metatarsal bones. This is often associated with the wearing high-heeled shoes or shoes with a narrow toe box, forcing the toes into an unnatural position and increase the risk of nerve compression from the bones.

The symptoms of Morton's Neuroma can vary from person to person, but they commonly include a sharp, shooting pain or a burning sensation in the ball of the foot. Some individuals may feel as though they are standing on a pebble or a fold in their sock. Tingling and numbness may also be present in the affected toes. These symptoms can gradually worsen over time if nothing is done to help the problems. The diagnosis of Morton's Neuroma is usually based on the clinical symptoms and the use of imaging tests, such as X-rays or MRI scans to rule out other potential causes of the symptoms.

The treatment of a Morton's Neuroma will depend on the severity of the condition and how long it has been present. The initial approach is to modify or change the footwear. Wearing shoes that have a wider toe box and lower heels can help reduce pressure on metatarsal bones and the affected nerve. Shoe inserts or foot orthotics that can provide additional cushioning and support to the foot make help the symptoms, especially if they have a metatarsal pad to spread the metatarsal bones. Different types of pads or tape can be applied to the affected area to redistribute pressure and provide relief. If these measures do not help, then injections of corticosteroids near the affected nerve can help reduce inflammation and relieve pain. There are also sclerosing injections can be used where a solution is injected into the neuroma to shrink the tissue and alleviate symptoms. If these conservative and injection therapies are not helpful, surgical removal of the neuroma may be necessary in severe cases. This is usually a last resort and aims to eliminate the source of irritation.

Morton's Neuroma is a reasonable common painful foot condition that can significantly impact a person's quality of life. Understanding the causes, symptoms, diagnosis, and treatment options associated with this condition is crucial for people with the disorder. Most cases are managed with wider fitting footwear and metatarsal pads with only a few going on to need surgery.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.