Morton's Neuroma

Have you ever had a pebble in your shoe? A foot condition called Morton’s Neuroma can feel like you are walking on a small rock or marble except that there isn’t something inside your shoe.

A neuroma is a benign tumor of the nerve and occurs most often between the third and fourth toes.

Make Smart Shoe Choices

  • Switch high heels for lower heels to avoid the forefoot “pushing-off” when walking
  • Try wider shoes with a cushioned insole that do not compress the toe bones
  • Avoid tight fitting shoes; allow ample room in the toe box

What are the symptoms of Morton’s Neuroma?

  • Pain in the forefront of the foot that radiates into the toes
  • Burning or tingling
  • Sensation of a foreign object under the foot
  • Pain when touching the affected toes

Diagnosing Morton’s Neuroma

During the examination, I feel for a literal “click” when applying pressure to the toes. I apply pressure between the toe bones to try and replicate the pain or look for evidence of what may be causing the pain. In difficult to diagnose cases, I can use ultrasound, MRI, and diagnostic injection can be utilized as well.

What are the risk factors of Morton’s Neuroma?

Risk factors associated with development of a neuroma include:

  • Flat or very high-arched foot types
  • Wearing tight fitting or high-heeled shoes
  • Obesity
  • Certain types of high-impact sporting events

Non-Surgical Treatment Options Can Help

I first look at conservative treatment options such as recommending better fitting, more supportive shoes, and reviewing your day-to-day activities. Additional treatment options include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs).
  • Custom orthotics with a built-in metatarsal pad.
  • Corticosteroid injections.

If these options aren’t providing the best outcome, we can consider surgery to remove a part of the nerve or release tissue that is causing the pain. This is a fairly routine procedure with reported success rates of greater than 90 percent.

October 4, 2019 | by Edward J. Chesnutis III, DPM, FACFAS