Morton’s Neuroma: Symptoms, Causes & Treatment

Morton’s Neuroma is a condition that often flies under the radar but can cause significant discomfort. This post by Manly Cove Podiatry aims to shed light on its symptoms, underlying causes, and available treatments. Understanding Morton’s Neuroma is the first step towards effective management and relief.

What is Morton’s Neuroma?

Morton’s Neuroma is a painful condition affecting the ball of your foot, most commonly the area between your third and fourth toes. It involves the thickening of the tissue around one of the nerves leading to your toes. This thickening can cause sharp, burning pain and discomfort in the ball of the foot. People describe the sensation as having a pebble in their shoe. Although not a true neuroma, which is a nerve tumour, it mimics the symptoms of one, leading to its naming.

Symptoms of Morton’s Neuroma

The initial signs of Morton’s Neuroma include a tingling sensation between the toes, which can progress to sharp, shooting pains or numbness in the ball of the foot when wearing tight shoes or performing certain activities. Some individuals might also experience a burning pain in the affected area.

How Symptoms Progress Over Time

As the condition worsens, the temporary pain can become more persistent, affecting daily activities. The pain might spread to the toes or the ball of the foot might feel swollen. Walking or any pressure on the foot exacerbates the discomfort, making it difficult to wear regular shoes without significant pain.

When to Seek Medical Advice

It’s crucial to consult a healthcare professional if:

• The pain persists for more than a few days
• You experience severe pain and swelling near the ball of your foot
• The pain interferes with walking and daily activities

Early diagnosis and treatment can prevent further complications and improve quality of life. A podiatrist, specialising in foot conditions, can offer the most targeted advice and treatment options.

Causes and Risk Factors

Understanding the causes and risk factors of Morton’s Neuroma is pivotal in both preventing and addressing this foot condition. Here, we’ll explore the main causes, lifestyle and genetic predispositions, and the impact of footwear and physical activities that contribute to its development.

Main Causes of Morton’s Neuroma

Morton’s Neuroma is not caused by a single factor but is the result of a combination of conditions that exert pressure or irritation on the foot nerves. The primary cause is the thickening of the tissue surrounding the nerves leading to the toes, which is often a response to irritation, trauma, or excessive pressure.

Risk Factors Including Lifestyle And Genetic Predispositions

Several risk factors increase the likelihood of developing Morton’s Neuroma:

• Footwear: High heels or tight-fitting shoes that compress the toes can contribute to the development of Morton’s Neuroma.
• High-Impact Sports: Activities that involve repetitive pressure on the foot, like running or tennis, can exacerbate the condition.
• Foot Deformities: People with bunions, hammertoes, high arches, or flat feet are at a higher risk due to the increased pressure on the ball of the foot.
• Occupation: Jobs that require being on your feet for long periods, especially in tight footwear, can increase risk.

Relationship With Footwear and Physical Activities

Footwear that narrows at the toe box can compress the metatarsal bones and irritate the nerve between them, leading to Morton’s Neuroma. Similarly, physical activities that involve significant pressure on the balls of your feet can aggravate the condition. Choosing the right footwear and using appropriate protective padding can mitigate these risks.

Diagnosis of Morton’s Neuroma

Diagnosing Morton’s Neuroma involves a combination of patient history, physical examinations, and imaging tests. A podiatrist or healthcare professional will start by discussing symptoms and conducting a thorough examination of the foot. They may apply pressure to the foot or manipulate it to replicate the pain.

Physical Examination

The doctor may perform a Mulder’s test, where pressure is applied to the sides of the foot while simultaneously squeezing the metatarsal joints together. A clicking sound or a reproduction of symptoms indicates the presence of Morton’s Neuroma.

Imaging Tests

While physical examinations can suggest Morton’s Neuroma, imaging tests confirm the diagnosis:

• Ultrasound: This is often the first imaging test ordered as it’s effective in visualising soft tissue and can show the thickened nerve.
• MRI (Magnetic Resonance Imaging): Although more expensive, an MRI provides detailed images and is useful in ruling out other conditions.

Treatment Options for Morton’s Neuroma

Navigating the treatment options for Morton’s Neuroma is essential for finding relief and regaining foot health. In the sections that follow, we’ll cover both nonsurgical and surgical treatments, detailing their effectiveness, to guide patients toward the most appropriate care for their condition.

Nonsurgical Treatment Options And Their Effectiveness

Many cases of Morton’s Neuroma can be effectively managed without surgery. The primary goal of nonsurgical treatments is to relieve pressure on the affected nerve and alleviate pain.

Orthotic Devices

Custom orthotic devices can provide support and reduce pressure on the nerve. These devices are inserted into the shoe and can help distribute pressure more evenly across the foot, reducing irritation on the neuroma.

Changes in Footwear

Switching to shoes with a wider toe box and lower heels can significantly reduce pressure on the toes and the balls of the feet, offering immediate relief in many cases. Shoes designed for stability and support can also be beneficial.

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. In some cases, corticosteroid injections or alcohol sclerosing injections are administered around the affected area to reduce pain and swelling.

Physical Therapy

Physical therapy can be an effective treatment for Morton’s Neuroma. Exercises aimed at strengthening the foot, improving flexibility, and reducing pressure on the nerve can help manage symptoms. Massage and ultrasound therapy may also be used to relieve pain and inflammation.

Surgical Options And When Surgery Is Considered

Surgery is typically considered when nonsurgical treatments fail to relieve symptoms. The decision to proceed with surgery depends on the severity of the symptoms and the patient’s lifestyle and needs.

Types of Surgery for Morton’s Neuroma

• Neurectomy: The most common surgery for Morton’s Neuroma involves removing the affected nerve. While this can provide relief, it may also result in permanent numbness in the toes.
• Decompression Surgery: Instead of removing the nerve, some surgeries aim to relieve the pressure on the nerve by cutting nearby structures, such as the ligaments binding the bones in the front of the foot.

Recovery Process and What to Expect

Recovery from Morton’s Neuroma surgery varies with the type of procedure performed. Patients may need to wear special footwear or a cast and limit weight-bearing activities for several weeks. Physical therapy is often recommended to restore strength and mobility. Most patients experience relief from pain after recovery, but as with all surgeries, there are risks of complications or recurrence.

Preventative Measures

Preventing Morton’s Neuroma involves understanding the risk factors and implementing strategies to reduce foot stress. While not all cases can be prevented, especially in individuals with certain foot shapes or genetic predispositions, many strategies can significantly lower the risk of developing this painful condition.

Tips For Preventing Morton’s Neuroma

1. Choose the Right Footwear: Opt for shoes with a wide-toe box and low heels to minimise pressure on the front of your feet. Avoid tight-fitting shoes and high heels whenever possible.
2. Use Orthotic Inserts: For those with high arches, flat feet, or other foot deformities, custom orthotic inserts can help distribute pressure more evenly.
3. Limit High-Impact Activities: If you’re involved in high-impact sports, consider mixing in low-impact exercises such as swimming or cycling to reduce stress on your feet.
4. Maintain a Healthy Weight: Extra weight can put additional pressure on your feet, increasing the risk of Morton’s Neuroma.

Importance of Proper Footwear

Proper footwear is crucial in preventing Morton’s Neuroma. Shoes that provide adequate room for the toes and support the arch can prevent the undue pressure that leads to nerve irritation. Investing in quality shoes that fit well is a simple yet effective way to protect your feet.

Recommended Exercises and Lifestyle Adjustments

Regular foot exercises can strengthen the foot muscles, improve flexibility, and reduce the risk of foot problems. Toe stretches, calf raises, and towel curls are beneficial exercises. Additionally, maintaining a healthy lifestyle that includes regular exercise and a balanced diet can prevent excessive stress on your feet.

Living with Morton’s Neuroma

Adapting to life with Morton’s Neuroma involves managing symptoms and making informed lifestyle choices. The upcoming insights will focus on daily symptom management and the long-term outlook for individuals navigating this condition.

Managing Symptoms In Daily Life

Living with Morton’s Neuroma requires adjustments but can be managed effectively with the right strategies. Prioritising foot health, such as choosing appropriate footwear, utilising orthotic devices, and engaging in prescribed physical therapy exercises, can significantly alleviate symptoms. Pain management techniques, including over-the-counter pain relievers and avoiding activities that exacerbate the pain, are also key to maintaining a normal lifestyle.

Long-Term Outlook For Patients With Morton’s Neuroma

The long-term outlook for patients with Morton’s Neuroma is generally positive, especially with early diagnosis and treatment. Many individuals find relief through nonsurgical methods, and for those who require surgery, the success rates are high. With appropriate management, most people can return to their regular activities without chronic pain.

Conclusion

Understanding and addressing Morton’s Neuroma is essential for those affected by this condition. Through a combination of proper footwear, lifestyle adjustments, and medical treatment, individuals can manage symptoms and enjoy a high quality of life. Early intervention is crucial, so seeking professional advice at the first sign of discomfort can lead to the best outcomes.