Morton’s neuroma is caused by
the entrapment of the thickened nerve tissue between bones. It often occurs between the third and fourth metatarsal bones of the
foot. Thickening of the nerve is usually caused by an irritation and pinching of the nerve. Pain is usually worse when walking in
high heel shoes or in shoes that have a tapered toe box. In many cases, massaging the foot and
not wearing narrow shoes brings some relief.
This condition is more prevalent in people who wear narrow, high heel shoes
and individuals who have certain foot pathologies, such as bunions, hammertoes, flatfeet,
etc. It is fairly common in people who are involved in activities requiring constant
irritation of the forefoot (e.g. soccer, running, tennis)
Also, a trauma to the foot can result in irritation of the nerve
and formation of the intrametatarsal neuroma.
What are the signs and symptoms?
• Pain in the toes and up the leg
• Tingling, burning, numbness
• Constant feeling there is something inside your foot or a rise inside the shoe
Before starting treatment,
a proper assessment by a chiropodist/podiatrist or family physician is required. Other conditions, such as bursitis and capsulitis, can also occur in this area with similar signs and symptoms. A high success rate is
achieved by using physical modalities and a combination of wide toe box shoes
and custom made orthotics.
Other treatment modalities
include corticosteroid injections,
sclerosing injections (chemical sympathectomy type procedure)
and surgery. Surgery is considered when everything else fails and consists of complete excision of the irritated nerve. To prevent Morton’s neuroma, wear wide shoes and reduce activities that are putting a lot of stress on your feet. Don’t ignore the pain. Have it checked by a foot specialist.