Understanding Morton's Neuroma
Morton's neuroma is a condition involving thickening of the tissue surrounding a nerve between the bones of the toes, most commonly between the third and fourth toes, causing sharp, burning, or tingling pain in the ball of the foot.
Unlike metatarsalgia, which involves general pain from joint or bone overload, Morton's neuroma is specifically a nerve-related condition, often triggered or worsened by tight, narrow footwear.
What Causes Morton's Neuroma?
- Wearing narrow, tight-fitting, or high-heeled shoes that compress the forefoot bones
- Repetitive physical stress from running or high-impact athletic activity
- Foot deformities such as bunions or hammertoes altering normal pressure distribution
- High arches or flat feet contributing to abnormal forefoot mechanics
Symptoms
- A sharp, burning, or tingling pain between the toes, most frequently between the third and fourth
- A distinct sensation of standing on a pebble or a folded crease in a sock
- Numbness or paresthesia that may radiate outward into the affected toes
- Pain that often improves when shoes are removed or the forefoot is massaged
Diagnosis
Diagnosis is typically based on a characteristic clinical history and physical examination, including specific forefoot compression tests that reproduce the burning pain.
Ultrasound or MRI can confirm the diagnosis and assess the exact size of the thickened nerve tissue in more persistent cases.
Treatment Approach
- Footwear changes: Switching to wider, well-cushioned shoes featuring a roomier toe box
- Orthotic support: Utilizing metatarsal pads or custom orthotics to offload pressure on the affected nerve
- Activity modification: Reducing aggravating high-impact loading during exercise
- Injections: Corticosteroid injections to manage persistent inflammation and pain
- Surgical excision: Surgical removal of the neuroma considered for cases unresponsive to conservative treatment
Frequently Asked Questions
Is Morton's neuroma the same as metatarsalgia?
No, Morton's neuroma is a specific nerve-related condition causing burning or tingling pain between the toes, while metatarsalgia refers more broadly to general pain in the ball of the foot from joint or bone overload.
Can Morton's neuroma go away without treatment?
Mild cases can improve significantly with footwear changes and activity modification, though more established neuromas may require additional treatment such as targeted injections or surgery.
What shoes should I avoid with Morton's neuroma?
Narrow, tight-fitting, or high-heeled shoes should be strictly avoided, as they squeeze the forefoot bones together and significantly worsen nerve irritation.
Take Care of Your Foot Health
Concerned about ankle or foot pain? Book a consultation today with our specialists.
Book Specialist Consultation