Morton’s neuroma is a specific type of neuroma which occurs between the third and fourth toes commonly but can also occur between the second and the third one. A neuroma is the thickening of nerve tissue developing in different parts of the body.
It is a non-cancerous (benign) swelling but once the swelling begins a pressure is faced by the nearby nerves through bones and ligaments surrounding it resulting into irritation as well as inflammation. It is also called by several other names like interdigital neuroma, forefoot neuroma and intermetatarsal neuroma.
Intermetatarsal term is based on its location in the ball of the foot between metatarsal bones. The cases of Morton’s neuroma are 8 to 10 times greater in women as compared to men because of wearing high heeled and narrow shoes. As this type of shoes tends to shift the bones of the feet into an abnormal position this increases the risk. Being overweight can also increase the chances of suffering from Morton’s neuroma.
The exact causes of Morton’s neuroma in several cases remain unknown. Sometimes it may result from an injury in the foot which comes from the nerve to the toe which is stressed excessively or mashed. Many other things are too responsible for Morton’s neuroma.
Firstly, the shoes that are tight or have high heel can put pressure on the balls of the feet. The shape of the shoes like narrow from the toes also triggers Morton’s neuroma. These shoes can make the nerves in the feet irritated and compressed.
Further, the irritated nerve becomes thick and gradually more painful finally resulting in this type of neuroma. High impact activity, all sports such as excessive running, racket sports or ballet put excess stress on the feet gradually developing Morton’s neuroma. Snow skiing or rock climbing which require wearing long and tight shoes also cause this.
Other possible reasons include the improper manner of walking with toes in imperfect direction, people suffering from other problems of the foot such as – hammertoes (a toe bent permanently downwards), flat feet (a condition in which the entire sole of the foot touches the floor while standing), overly high arches (cavus foot in which the foot has a very high arch due to which an excessive weight is placed on the ball of the foot), and bunions (a bump at the
base of the big toe).
Sometimes one may have Morton’s neuroma without any symptoms but most often directly it can be felt. The most common symptom of Morton’s neuroma is an intermittent pain and the patient suffering from it may feel a burning pain in the ball of the foot having a feel as standing with a pebble in the shoe. Due to this, there is difficulty in walking normally. Though any type of swelling may not be observed on the foot, the pain usually increases by walking or when the ball of the foot is squeezed together. This pain may force the person to stop walking or to limp
from the pain. Sometimes the pain may be dull rather than a sharp one.
Paresthesia a tingling, pricking or numbness with no apparent long-term physical effect known as pins- and -needles are other symptoms of Morton’s neuroma.
Symptoms can be continuous, lasting for several days and weeks and become so severe that
can stop the person to even place the foot down on the ground.
Morton’s neuroma can be diagnosed readily by a physician putting pressure on spaces between the third and fourth toe bones, looking for the area of tenderness, swelling, numbness and muscles weakness. The doctor will squeeze the sides of the foot to check the compression and trigger the typical pain zone. Inquiring about the type of shoes worn, the sports activities in which the person is involved and earlier foot-related disease symptoms play
an important role in diagnosing Morton’s neuroma.
Post physical examination based on the information, an x-ray may be suggested to assure the absence of foot fracture. Still, if there is uncertainty an MRI of the foot is the next step as it often indicates neuromas in such people who have no symptoms at all. Ultimately after finding out the actual location and causes of it the doctor will suggest for the suitable treatment options to the patient.
In the cases where the pain is felt the doctor usually suggests conservative therapies like wearing low heel shoes having wide space near toes, to use metatarsal pads or toe crest pads, shoe inserts that prevent an imbalance of the foot. An injection of anesthesia into the affected location can be given for relief. Anti-inflammatory medicines like Ibuprofen or naproxen too are recommended. If the pain still persists a surgery is required to remove the
neuroma or widen the space.