Morton's Neuroma

Are you experiencing sharp, stabbing pain at the base of your toes. Maybe tingling, burning or sometimes numbness?

Often times patients will tell me that it feels as if there is something inside the ball of the foot.  Or, that it feels like there is a “sock” bunched up. 

To alleviate the symptoms, patients will have to take off their shoes and rub their feet. If this sounds like something you are experiencing, then you may have a "Morton’s Neuroma". These are all classic symptoms of this painful condition.

A Neuroma is a thickening or “bulging” of a nerve tissue.  It can happen anywhere in the body and anywhere in the foot. 

However, the most common area in the foot is called a Morton’s Neuroma. 

It typically develops between the base of the third and fourth toes.  It is basically a swollen, inflamed nerve.  The symptoms develop slowly. 

Certain types of shoes can irritate the nerve, producing that very unpleasant sharp pain. By messaging the foot, the pain may go away temporarily. 

Over time, the symptoms of a neuroma can get worse and last for days or weeks.  It is better to treat this nerve condition in its earliest stages, to prevent the changes in the nerve from becoming permanent.

The cause of a neuroma is from compression on the nerve.  Certain foot types lend itself to be more prone to the development of this condition. 

This includes flatfeet, bunions or hammertoes.  Other causes are wearing tight, tapered toe box shoes, or high heels.  Repetitive activities, such as tennis or running can also be responsible for
bringing this on. 

Also, trauma or injury to the nerve can set up this condition.

To lessen the severity of this condition and prevent the need for more invasive treatment, it is best to begin treatment with your Podiatric surgeon as soon as symptoms occur.

Your podiatric surgeon can typically diagnosis your condition, simply on physical exam.  This is done by squeezing the metatarsal together to try to elicit a mulder’s sign. 

This is a classic sign that produces an audible click and reproduces the pain.  Xrays are taken to rule out any other bony abnormalities, such as a fracture, and to evaluate the foot structure. 

Also, and MRI scan can be done to confirm the suspected diagnosis and make sure there are not any other conditions causing pressure on the nerve, such as a tumor.

For mild cases of neuroma, teatment options include:

1.  Padding:  Your podiatrist surgeon can instruct various padding techniques that will help take the compression off the nerve. 

2.  Orthotics:  Custom made devices are very good for this condition, as it will support the arch and reduce compression on the nerve.

3.  Change in shoe wear:  Avoid narrow, tapered toe shoe.  Stick with a wide toe box.  Avoid high heels.  Try shoes with a wedged heel.

4.  Change in activities:  Avoid repetitive activities.  For the competitive athlete, this is often not an option. However, a temporary rest from the activity may be needed to allow the nerve to heal.  For this person, a custom made orthotic should be greatly considered.

5.  Medication:  Anti-inflammatory medications, such as Motrin, Aleve, Advil will help to reduce the swelling around the nerve, and decrease the pain.

6.  Injection therapy:  A cortisone injection may be tried, if other treatments fail.

Sometimes all noninvasive treatment fail to alleviate the symptoms of a neuroma and Surgery may be the next step. 

Surgery consists of removing the affected nerve.  Recovery time may vary, however, it is generally two to four weeks. 

The surgical outcome is usually highly successful.  Your podiatric surgeon will discuss with you the risks and benefits from surgery, and long term treatment options.

If you live in South Florida, and you would like a consultation with me, please call my office at:

In or near Boynton Beach, call 561-734-4867

In or near Wellington, call 561-433-5577.