A neuroma definition describes a growth, or benign tumor, in nerve cells of the foot. A Morton’s neuroma is when the inflamed nerve, which is not an actual tumor but a thickening of the tissue that surrounds the digital nerves leading to the toes, is located between the third and fourth toes. It occurs as the nerve passes under the ligament connecting the toe bones (metatarsals) in the forefoot, and usually develops in response to irritation, trauma or excessive pressure.
Normally, there are no outward signs, such as a lump, because the nerve is deep within the foot. Morton’s neuroma is a painful condition which can cause a sharp, burning pain in the ball of the foot. The toes may also sting, burn or feel numb. Patients often compare the feeling to that of standing on a pebble in his or her shoe. The most common symptom is the burning pain in the ball of the foot that may radiate into the toes which may intensify with activity or wearing poorly fitted shoes. There may also be numbness in the toes, or an unpleasant feeling in the toes. Runners may feel pain as they push off from the starting block. High-heeled shoes, which put the foot in a similar position to the push-off, can also aggravate the condition. Tight, narrow shoes also aggravate this condition by compressing the toe bones and pinching the nerve.
Examination usually reveals a mass that can be felt between the toes and a “click” may occur when pressure is applied between the bones which may replicate the pain. Other conditions will also be excluded by examination and x-rays.
Treatment generally involves changes in footwear with the avoidance of high heels or tight shoes, allowing the bones to spread out and may reduce pressure on the nerve, giving it time to heal. Custom or over-the-counter shoe inserts and pads also help relieve irritation by lifting and separating the bones, reducing the pressure on the nerve, and on occasion, an injection of a corticosteroid medication is necessary to reduce the swelling and inflammation of the nerve.
If conservative treatment does not relieve symptoms, surgery may be considered. This specifically involves resecting a small portion of the nerve and releasing the tissue and ligaments overlying the nerve. This outpatient procedure can be performed under ankle block anesthetic (local anesthetic) and involves two weeks in a rigid orthopedic shoe with immediate weight bearing. Transition to a regular shoe occurs as soon as swelling allows.
When we walk, all pressure is transferred to the feet. It’s these two crucial appendages that support the body and allow for all acts of motion to occur. A Morton’s neuroma can seriously affect the ability to efficiently bear weight and makes walking without pain incredibly difficult. For the best neuroma treatment in Illinois, consider the professional assistance from Dr. Anand Vora. His orthopedic expertise on the foot allows him to diagnose and treat patients with the utmost care. To explore neuroma relief options and compassionate support, please contact Dr. Vora today to schedule your appointment.
Modified from the AAOS