Morton's Neuroma

Morton’s neuroma is pain, numbness, or tingling in the forefoot, especially between the 3rd and 4th toes. The pain is due to the thickening of the nerve that supplies the sensation to the area between the toes. 

Other names for the condition are Morton’s metatarsalgia, Morton’s neuralgia, plantar neuroma, and intermetatarsal neuroma.

Morton’s neuroma is a sharp, burning pain or numbness and tingling between two toes which can extend outwards or involve the whole side of your foot. The pain is most often described as a burning discomfort in the forefoot however aching or sudden shooting pain in the forefoot is also common.

The pain in the forefoot can be intermittent at first but it may become more frequent as time progresses. It often becomes worse when wearing shoes or with activity and is usually aggravated by squeezing the foot. 

The condition most commonly occurs in women (it is estimated to occur in women 8-10 times more often than men). It is termed Morton’s neuroma when it occurs between the third and fourth toes; if the condition appears between other toes it is just called neuroma.

Morton's neuroma seems to occur in response to irritation, pressure or injury to one of the nerves that lead to your toes. Constant irritation/pressure causes the nerve to thicken in response and cause Morton’s neuroma to develop.

The most common cause of this condition is wearing narrow or high-heeled shoes that force the toe into a tapered toe box. Extensive wear of tight fitting or high heeled shoes adds pressure to the nerves and puts you at risk of developing Morton’s neuroma.

High impact activities (such as running or jogging) which put pressure on the ligament can also cause the nerve to thicken over time. So can sports that require tight fitting shoes, such as skiing. 

Deformities such as hammer toes, bunions, and flat feet can also cause the ligament to press on the nerve, adding pressure and putting you at risk of developing Morton’s neuroma.

Once formed, Morton’s neuroma will not go away on its own. 

That said, there are ways that the pain caused by it can improve or disappear. The earlier you receive treatment for Morton’s neuroma, the higher your chances of pain resolving. 

In more advanced cases, the pain may return in episodes if you have been on your feet for a long period of time or continue to wear tight-fitting shoes. Repeated treatments or surgery may be required in these instances.

For patients who are not responding to non-surgical treatments, surgery may be necessary. 

The length and recovery period varies from patient to patient. The typical approach taken is to remove a portion of the nerve or release tissue around the nerve to relieve pressure. Although the surgery is usually successful, there is a potential for permanent numbness in the affected toes.

Fortunately there are many good habits you can form to reduce your chances of developing Morton’s neuroma. These include: