What is it?
Morton`s neuroma is the irritation and compression of a common plantar digital nerve in your foot, often causing numbness and tingling in the toes. With a true neuroma, this compression is a result of thickening of the tissue around the nerve itself. Morton’s neuroma (named for the first doctor to describe the condition), most commonly affects the common plantar digital nerve between the third and fourth metatarsal bones, which causes pain in the third and fourth toes.
What do people experience?
Symptoms can include:
- Numbness
- Tingling
- Shooting pain
- Burning pain
- Radiating pain to adjacent toes
- Feeling as though sock is bunched up or wrinkled
- Increased pain with activity
- Relief upon removal of footwear
Risk factors
Risk factors for discomfort include:
- High heels
- Tight or illfitting footwear
- High impact activity
- Other foot complications (bunions, hammertoes)
What can you do to feel better today?
- Ensure that footwear has adequate width and extra depth in the toe box. This will allow the foot enough room to splay and help minimize mechanical compression of the common digital nerve from the shoe.
- Try Metatarsal pads. These work to offload the neuroma by supporting your distal transverse arch. Metatarsal pads can be incorporated into a shoe on its own or on a custom made orthotic.
- Decrease high impact activities. High impact activity can increase pressure on the feet and worsen symptoms. Reducing this type of activity and ensuring the use of proper footwear can aid in prevention of symptoms.
- Maintain a healthy weight, which can reduce physical stress and pressure on the foot. Consult your family physician or a dietician for more information and directives.
What are my options for treatment? Who can help?
A stepped approach is often taken for the treatment and management of Morton`s neuroma, moving from least invasive to most invasive. Less invasive treatments include metatarsal pads, footwear modifications, and offtheshelf (OTS) and custom foot orthotics. These options can be discussed with your pedorthist and other healthcare professionals for conservative treatment of symptoms.
More invasive options, such as medication, corticosteroid and sclerosing alcohol injections, and surgery, may be discussed with your family physician to determine an appropriate treatment plan.
Prevention/Prehabilitation
Although the exact cause of Morton’s neuroma is unknown, possible causes include irritation, pressure, or injury to the common digital nerve. Proper Footwear is a crucial factor in prevention of pain.
Staying active with pain
Staying active with Morton’s neuroma is possible. Choosing appropriate type and fit of footwear for the given activity is crucial. Footwear should provide adequate width and depth to reduce mechanical pressure on the foot. High impact activity can increase the amount of stress placed on the foot, increasing irritation and worsened symptoms. Choosing lower impact activities can reduce stresses.