Morton’s Neuroma: What Is It and How Do I Treat It?

Article Highlights:

• Morton’s neuroma is a common condition that causes pain in the ball of the foot, usually between the third and fourth toes.

• Tight and narrow footwear, different types of feet and walking, and certain sports are some of the factors that have been linked to Morton’s neuroma. 

• Morton’s neuroma is more common in women than in men and in people who regularly wear high-heeled or tight shoes.

• The diagnosis of Morton’s neuroma involves a patient’s background, palpation, Mulder’s click test, and imaging in some cases.

• Treatment options include orthotics, padding, laser treatment, injection therapy, radioablation, and surgical referral in severe cases where conservative treatment has failed.

Morton’s neuroma is a common condition characterised by pain in the ball of the foot, typically between the third and fourth toes.

We see Morton’s neuroma patients on a regular basis at Hurst Podiatry, and we’re here to help you understand this condition and what you can do to manage it.

What exactly is Morton’s neuroma?

Morton’s neuroma is an inflammation, irritation, and/or swelling of some of the small nerves that run between the metatarsals.

It is most common between the third and fourth metatarsals because this space is slightly more crowded than the other metatarsal spaces because two nerves frequently occupy the same space, whereas the other intermetatarsal spaces typically only have one nerve channel.

However, while Morton’s neuroma is much less common in other metatarsal spaces, the second and third spaces are the next most common.

What are the symptoms?

The following are the most common Morton’s neuroma symptoms:

• Pain in the ball of the foot that may radiate to the toes or up the leg.
• Numbness or tingling in the toes: A sensation of numbness or tingling in the toes.
• Swelling: Inflammation and swelling in the ball of the foot.
• Cramping or stiffness in the toes or ball of the foot.
• Walking difficulty: Pain and discomfort while walking, especially when wearing tight shoes.
• A lump sensation is the sensation of a small, hard lump under the foot.

How do you get Morton’s neuroma? What causes it?

A number of factors have indeed been linked to Morton’s neuroma, including:

• Tight and narrow footwear that causes plantar compression and squashing of the new nerve, which can result in a neuroma.
• Different types of feet and walking. This may be difficult to explain, but incorrect forefoot movement creates a shearing force between the metatarsals. This force can irritate nerves and result in a neuroma.
• Sporting footwear or certain sports, such as football and soccer, require narrower boots and involve a lot of changing directions; this combination can often result in a neuroma.

Can Morton’s neuroma cause other problems?

Morton’s neuroma is particularly associated with other forefoot conditions such as osteoarthritis and bursitis.

Because of the overlap of risk factors and causes, it is often difficult to say what is causing what. We frequently see Morton’s neuroma alongside these other conditions and need to treat all of these conditions to ensure we’re getting the best outcome.

What sort of individuals are more prone to Morton’s neuroma, and how common are they?

Morton’s neuroma can occur in anyone, but it is more common in women than in men.

It is also more common in people who regularly wear high-heeled or tight shoes or who engage in activities that place repetitive pressure on the feet, such as running or jumping.

It is a relatively common condition that affects about one in every 300 people.

How do your podiatrists diagnose the condition?

1.     Patient Background

The first step in diagnosing Morton’s neuroma is to take your detailed medical, surgical, and footwear histories. This will help us determine if you have any of the risk factors associated with this injury. It will also prompt us to perform additional tests to rule out any additional injuries.

2.     Palpation

The next assessment will involve touching or palpating your foot to determine the source of the pain. As we mentioned earlier, Morton’s neuroma is most commonly found in the third intermetatarsal space, but it can also occur in the second or fourth intermetatarsal space. If we discover that the pain is coming from one of these areas, we will proceed to the next assessment to confirm our suspicions.

3.     Mulder’s Click Test

The next evaluation conducted is known as the Mulder’s click test. Squeezing the forefoot mediolaterally is required for this test. A positive test will cause the forefoot to click or crunch. Because of the compression of the nerve, this may cause symptoms such as numbness, tingling, or pins and needles.

4.     Imaging

In some cases, imaging may be necessary to confirm the diagnosis, and rule out other conditions such as fibroma or a stress reaction of the metatarsals. This step may not be necessary if all of the previous tests have proven that you have Morton’s neuroma. However, if we have any doubts, we may refer you for an x-ray and/or an ultrasound. This can help us determine the exact cause of pain and discomfort.

What are the available treatment options?

We can assist with a variation of Morton’s neuroma treatment options, including advising you on the best types of footwear to wear to minimise the effects of your neuroma. Some of the other treatment options include:

• Orthotics can be used to control the walking and running movements that cause a morton’s neuroma in the first place.

• Padding, particularly the use of a metatarsal dome, can be beneficial in opening up the space between the bones and relieving compression.

• Laser treatment can be an excellent way to relieve nerve pain and inflammation.

• Injection therapy can be recommended. This can be achieved by injecting a substance such as a corticosteroid into the neuroma to reduce inflammation.

• In more severe cases where conservative treatment has failed, surgical referral may be necessary. In this case, we can refer you to a surgeon.

• Radioablation is a fantastic non-surgical option for neuroma in which a nerve block is performed followed by a single injection to “melt” the nerve and dissolve the neuroma. We can provide additional information as well as a referral for the procedure.

Can it be prevented?

If you’ve had Morton’s neuroma in the past, you’re more likely to get it again. However, taking steps to manage your symptoms and reduce your risk factors can help reduce your risk.

While there is no foolproof way to avoid Morton’s neuroma, wearing comfortable shoes with a wide toe box and avoiding activities that place repetitive pressure on the feet may help reduce your risk. Using orthotics to control the types of movements that normally cause neuromas can be very effective.

When should I consult a podiatrist about this problem?

If you’re experiencing persistent foot pain or discomfort, you should consult a podiatrist.

Morton’s neuroma is a painful foot condition that can have a negative impact on one’s quality of life. It is critical to understand the causes, symptoms, and treatment options available in order to relieve pain and prevent further damage to the foot.

Hurst Podiatry is here to help you manage your foot health. Our experienced podiatrists are committed to providing personalised and effective care for Morton’s neuroma patients, utilising cutting-edge technology and techniques to achieve the best possible outcome. We believe in a team approach to care, and will work with you to develop a treatment plan that is tailored to your specific needs.

Call Hurst Podiatry today to make an appointment and take the first step towards a pain-free future. Don’t let Morton’s neuroma hold you back from living your life to the fullest.