Morton’s neuroma

What is Morton’s neuroma?

A Morton’s neuroma occurs when a nerve in your feet and between your toes becomes inflamed. While a Morton’s neuroma is not actually a tumor, as the name implies, the foot condition does create the sensation that you are walking on a pebble or a marble as if there were a growth in your foot. Morton’s neuroma can be very painful to walk on due to the heightened sensitivity of the affected nerve along with the thickening of the tissue surrounding the nerve. 

The condition is non-cancerous, and it does not lead to cancer. Over time, a Morton’s neuroma can cause permanent nerve damage in the foot. Typically, Morton’s neuroma occurs because of compression or irritation to the nerves between your third and fourth toes or your second and third toes. The condition is treatable to help manage symptoms and limit continuing nerve damage. 

What causes Morton's neuroma?

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While there is no known exact cause of a Morton’s neuroma, there is research that identifies triggers of the condition. The neuroma may start forming as the nerve’s response to its changing conditions and a feeling of compression. Once the nerve senses the compression, it could signal the swelling and production of tissue to protect and cushion the nerve. 

 

Even though scientists are still researching the condition to know more about the biological cause of the characteristics of a Morton’s neuroma, there is information of what activities and habits might be more likely to cause a Morton’s neuroma to form. 

  • Working long hours on your feet: Without proper rest, the nerves in your feet can become irritated and spur a Morton’s neuroma to form in response. 
  • Playing sports that repeatedly put pressure on the balls of your feet, such as tennis or running: These kinds of sports require prolonged pressure to run and change direction, which can trigger a Morton’s neuroma. 
  • Wearing ill-fitting shoes or shoes that are narrow, high-heeled, or pointed: Shoes like these force the foot into a tight space with no room to relax or decompress the nerves. 

In addition to what physical activities you do and what shoes you wear, there are some medical conditions that can also cause a Morton’s neuroma. Those medical conditions include:

  • Hammertoes 
  • Bunions 
  • Flat feet
  • High arches 
  • Trauma and injury to the foot

What are symptoms of Morton's neuroma?

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There are common symptoms of a Morton’s neuroma that should signal you to seek medical attention if you notice any new or worsening symptoms linked to the condition. Even though the condition is characterized by a feeling of something like a pebble or a marble on the bottom of your foot, there are typically not any outward signs of the condition that would be visible by examining the foot. 

 

Instead, look for the following symptoms of a Morton’s neuroma:

  • Tingling or numbness sensation in the toes around the neuroma, typically between the third and fourth or second and third toes
  • Pain between the third and fourth or second and third toes
  • Pain in the balls of the foot 

 

The condition typically affects one foot at a time, but the pain can radiate out from the location of the neuroma. You may notice that symptoms come and go or increase in intensity while wearing certain shoes or engaging in specific activities that aggravate symptoms. In addition, you may not notice any symptoms of a Morton’s neuroma and may establish a diagnosis only after seeking treatment for a different condition. How you experience symptoms of a Morton’s neuroma depends on your individual neuroma and your daily life and medical history. 

Are there any risk factors or groups for Morton's neuroma?

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Morton’s neuroma is a very common condition that is likely to impact 1 out of 3 people in their life. The condition is more likely to affect women and people aged between 50 and 60. There are some risk factors that contribute to a higher risk of developing the condition. These risk factors relate to lifestyle habits and your anatomy. 

Foot deformities: People with foot deformities are more likely to develop a Morton’s neuroma due to the potential stress the deformity puts on the nerves in the foot. Deformities like hammer toes, flat feet, high arches, and bunions can all place pressure on the nerves. While wearing the right shoes with good support reduces the risk of a Morton’s neuroma, the treatment for a neuroma tends to be more difficult if a deformity is the cause of the neuroma. 

Footwear: Frequently wearing shoes like high heels or other tight shoes increases your risk of developing a Morton’s neuroma. 

Physical Activities: People who participate in high-impact sports that involve continued pressure on the foot increase your risk. In addition, activities that require tight-fitting shoes and equipment like rock climbing or skiing can also increase your risk. 

How is Morton's neuroma diagnosed?

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To diagnose a Morton’s neuroma, you will need to consult with a doctor who will perform a review of your health history, conduct a physical exam, and possibly order imaging tests. Morton’s neuroma requires these three parts to confirm a diagnosis given the similarity of its symptoms to other foot conditions. 

During a review of your health history, the physician will attempt to understand your risk for the conditions and any previous injuries you have sustained in the foot. The doctor will also review the symptoms you have been noticing along with a review of your recent activities. This information can help your doctor know what might be the source of the symptoms and what seems to be triggering the symptoms to occur. 

After a review of your health history, your doctor will likely conduct a physical exam of the foot. The doctor will likely put some mild pressure on key areas of your foot to detect the source of any pain. In addition, your doctor may have you flex and point your feet to assess range of motion and feel for inflammation or swelling. 

To be certain of a Morton’s neuroma diagnosis, imaging tests can help rule out the presence of other foot conditions but will not show a neuroma in the image. An ultrasound can detect areas that appear abnormal, which may be a sign of a neuroma. All of these diagnostic techniques help your doctor or podiatrist make an accurate diagnosis of a Morton’s neuroma. 

How is Morton's neuroma treated?

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Morton’s neuroma is treated mainly through nonsurgical treatments that aim to manage the pain associated with the condition and reduce the swelling and inflammation around the nerve. If nonsurgical treatments are not successful, surgery may be needed to remove any dead portions of the nerve and surrounding tissue. 

Injections: Steroid injections into the nerve are a targeted treatment option meant to lessen the inflammation and swelling in the nerve as pain relief. 

Pain Relievers and Icing: OTC pain medications and ice packs can be effective for pain management if the pain from the neuroma is not severe. 

Footwear and Orthotics: Well-fitting shoes and the use of orthotics can help address the underlying cause of a Morton’s neuroma while giving the foot proper support and room to relax. 

Surgery: Surgery is typically a last resort option for people who do not respond to nonsurgical treatments. The surgery is not 100% successful and may not prevent a neuroma from forming again. 

Should you see a doctor for Morton's neuroma?

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You should see a doctor for any new or worsening foot pain. Your doctor will likely refer you to a podiatrist, who has specialized knowledge of foot conditions like Morton’s neuroma. Left unaddressed, a Morton’s neuroma can cause complications and be increasingly painful without the right treatment. 

 

Seek medical treatment if your pain does not improve within two weeks of noticing it has begun. A prompt diagnosis of a Morton’s neuroma can help prevent future occurrences of the conditions and can help you establish best practices when it comes to footwear and proper foot care. Because symptoms of a Morton’s neuroma can resemble those of other foot conditions, it is important to seek a differential diagnosis, to rule out the potential causes of the pain and identify the cause.

What is the outlook for people living with Morton's neuroma?

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Morton’s neuroma is a treatable condition, so the outlook is generally positive. There are effective measures to take to reduce the pain and other unpleasant symptoms of the condition with the right diagnosis and treatment plan. 

 

Morton’s neuroma can cause complications. The condition can make walking difficult, engaging in sports painful, and wearing certain shoes uncomfortable. While these complications are not life threatening, they are a good reason to seek proper care for your feet when you notice symptoms. 

 

Some measures are in your control to prevent a Morton’s neuroma from developing. For example, you can make smart choices when it comes to footwear by avoiding tight shoes or high heels. In addition, you can wear shoes that allow room for your toes and whole foot to relax. Orthotic inserts may also help support your foot and distribute pressure more evenly. 

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