The name Morton’s neuroma is a little misleading as a neuroma is a benign tumor that grows on nerve cells. A Morton’s neuroma is not growth but it does affect the nerves. It occurs when a nerve between two of the toes becomes compressed, causing it to become painful and inflamed. It can happen to a nerve between any toes but it most often affects the ones between the third and fourth toes as the gap between the metatarsals (long foot bones) is naturally smaller.
Morton’s Neuroma Symptoms
The first sign that you have Morton’s neuroma is a tingling feeling between your toes. This is where the growth is developing. Over time the tingling will become worse until it grows painful. The pain is felt not just between the toes but also in the ball of the foot and has been described as a shooting burning pain. It is often worse when walking and can be quite debilitating.
What Causes Morton’s Neuroma?
Morton’s Neuroma is caused by compression of the nerve between the toes, but what creates this compression isn’t exactly known. However, there are some factors that seem to increase the likelihood of contracting the condition.
1. Tight Footwear
The gap between the metatarsals is narrower between the second and third toes and the third and fourth toes. This is where Morton’s neuroma often arises and it is thought that tight-fitting shoes narrow the gap, even more, causing pressure on the nerve.
It is believed that running can cause Morton’s neuroma as it puts extra pressure on the nerve between the toes, which can cause it to become irritated. Some other sports are believed to increase the likelihood of developing the condition, but they all have running as a base.
3. Foot Conditions
If you have an existing foot problem then it is more likely that you will develop Morton’s neuroma than someone with no ailments. Conditions such as bunions, hammertoe, and high arches can realign the metatarsal bones, making them rub together. This can aggravate the nerve and lead to Morton’s neuroma.
Treatments for Morton’s Neuroma
There are a number of treatments for Morton’s neuroma, both surgical and non-surgical. The severity of the condition will dictate the type of treatment you need; often it can be treated at home without surgical intervention.
Non-Surgical Morton’s Neuroma Treatments
Footwear – We previously mentioned that ill-fitting footwear is thought to be a cause of Morton’s neuroma, so changing the shoes will help relieve the pain and reduce the swelling. Try not to wear pointed shoes or high heels very much as these are the worst culprits. It’s also a good idea to get your feet measured so you know exactly what size you are.
Orthotics – These are devices that are placed in the shoe to help support and realign the foot where necessary. They can help relieve pressure on the nerve and provide comfort for the feet.
Exercises – Calf-stretching exercises can sometimes relieve the pressure on the nerve. Your doctor will be able to advise you on which ones to do.
Over-the-counter medications – If Morton’s neuroma is painful then medication may be needed. Often painkillers that are available from pharmacies can tackle the pain. Anti-inflammatory painkillers are the best type as they should reduce any swelling as well.
Injections – If the pain is quite severe then your GP may suggest that steroids or local anaesthetic be injected into the area, thus numbing the pain.
Surgical Treatment for Morton’s Neuroma
Surgery is only called for if the above treatments do not work or if the condition gets worse. The surgery involves either making more space around the nerve (nerve decompression) or cutting it out completely (nerve resection). Both are relatively simple procedures that are done through a small incision in the foot.
Morton’s Neuroma Treatments
The condition can be treated in a number of ways; sometimes it can be managed with home remedies and exercises, but more serious cases may call for numbing injections or surgery.
The different treatments are detailed below. For more details on the condition in general visit our Morton’s Neuroma page.
It is believed that ill-fitting footwear can cause Morton’s neuroma as it squeeze the metatarsal bones (the long bones in the foot) together, causing the nerve at the base of the toes to become compressed and irritated. Pointed and high heeled shoes are particularly bad for this as the squich the toes and put pressure on them. Therefore, doctors advise that you should wear shoes that fit correctly and that do not rub or squeeze the feet.
It is a good idea to get your feet measured properly, you may believe that you are wearing the right sized shoes but feet can change shape over time and you may actually be wearing a size too small or big. Getting measured will ensure you know the exact size and can buy shoes that won’t worsen the condition
Also, avoid wearing high heels wherever possible as they put pressure on the toes. Save them for a special occasion!
Orthotics are cushioned soles that go in the shoes to provide support to the feet and help realign the bones. They can be used to relieve pressure on the nerve and therefore reduce the swelling and pain. They are not just designed for Morton’s neuroma but are used to treat a number of other foot ailments, such as bunions or high arches.
Orthotics can be bought from pharmacies without a doctor’s prescription but it is best to get a doctor or podiatrist to prescribe you a specific type so that they will work with your feet.
Sometimes exercising the calf muscles can help ease the pressure on the affected nerve in the foot. This should also help alleviative the pain. Only do exercises that a medical professional has suggested, otherwise you may cause more harm to the area.
Over-the-counter medicines are usually enough to treat the pain caused by Morton’s neuroma. Anti-inflammatory medicines, such as ibuprofen, are the best as they will help to reduce the swelling as well. Always ensure that you take the pills as described on the packet.
If medicine doesn’t ease the pain then your doctor may suggest getting injections to numb the area. These are usually a local anaesthetic or steroids which are injected into the affected part of the foot. Often, ultrasound is used to guide the needle to the right spot. This is effective as it gets to the correct part of the foot to relieve the pain.
If none of the above treatments work then surgery may be required. This is rare as Morton’s neuroma can usually be managed using at home treatments and medication, however, your podiatrist may suggest surgery if the pain is particularly bad or if the condition does not get better.
There are two types of Morton’s neuroma surgery; nerve decompression and nerve resection. In a nerve decompression procedure a doctor will make more space around the nerve so that it is not under so much pressure. This should relieve the irritation and pain.
Nerve resection involves removing the nerve completely and is only done in severe cases of Morton’s neuroma. This is effective as the cause of the pain is no longer there, however you can be left with less sensation in the area.
Both types of operation are performed through a small incision in the foot and it will take up to four weeks to recover from them.