Overview
Morton's neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. It involves a thickening of the tissue around one of the nerves leading to your toes, causing sharp, burning pain in the ball of your foot. Typically, there's no outward sign of this condition, such as a lump. Symptoms include a feeling as if you're standing on a pebble in your shoe, a burning pain in the ball of your foot that may radiate into your toes, and tingling or numbness in your toes. High-heeled or tight shoes have been linked to the development of Morton's neuroma. Treatment options may include switching to lower heeled shoes with wider toe boxes, corticosteroid injections, or surgery in severe cases. It's important not to ignore any foot pain that lasts longer than a few days and to see your doctor if you experience a persistent burning pain in the ball of your foot.
Understanding the disease
Symptoms
The symptoms of Morton's neuroma typically include a feeling as if you're standing on a pebble in your shoe, a burning pain in the ball of your foot that may radiate into your toes, and tingling or numbness in your toes. Other symptoms can include a loss of sensation or feeling in the affected toes. If the pain persists despite changing footwear and modifying activities, it's best to see a doctor.
Risk Factors
Risk factors for developing Morton's neuroma include wearing high heels, participating in high-impact athletic activities, wearing tight or ill-fitting shoes, and having certain foot deformities such as bunions, hammertoes, high arches, or flat feet. Other factors that may contribute to Morton's neuroma are foot trauma, metatarsal bone deformities, and tight or high-heeled shoes that compress the forefoot.
Development
Morton's neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. The thickening of the tissue around one of the nerves leading to your toes causes a sharp, burning pain in the ball of your foot. Morton's neuroma can develop due to several factors, including wearing high-heeled shoes or shoes that are tight or ill-fitting, participating in high-impact athletic activities, and having foot deformities such as bunions, hammertoes, high arches, or flat feet.
Assessment and Diagnosis
Triage
If you experience a burning pain in the ball of your foot that lasts longer than a few days and is not improving despite changing your footwear and modifying activities that may cause stress to your foot, it's best to see a doctor. This is particularly important if you suspect you have Morton's neuroma, as it is a painful condition that requires proper diagnosis and treatment. In some cases, corticosteroid injections or surgery may be necessary.
Diagnosis
To diagnose Morton's neuroma, your doctor will typically perform a physical exam by pressing on your foot to feel for a mass or tender spot, and potentially also checking for a "clicking" sensation between the bones of your foot. Imaging tests such as X-rays, ultrasound, or magnetic resonance imaging (MRI) may also be used to assist in the diagnosis, but X-rays and ultrasound are usually more commonly used and effective. An MRI is often used in cases where a diagnosis is uncertain or when considering surgical intervention.
Management and Treatment
Treatment
Treatments for Morton's neuroma may include the following options:
- Footwear adjustments: Wearing shoes with wider toe boxes and lower heels can help reduce pressure on the affected area. You can try switching to shoes with better support and cushioning to alleviate pain.
- Orthotics: Custom-made shoe inserts or orthotic devices can help distribute pressure evenly and support the affected area. These can be prescribed by a podiatrist or other healthcare professional.
- Corticosteroid injections: In some cases, corticosteroid injections may be administered to reduce pain and inflammation in the affected area.
- Physical therapy: A physical therapist can recommend exercises and stretches to help alleviate pain and improve foot function.
- Medications: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain associated with Morton's neuroma.
- Surgical options: In severe cases or when other treatments have been ineffective, surgical intervention may be considered. This could involve removing the affected nerve tissue or reconstructing the affected area. However, surgery carries the risk of complications and should be carefully considered. It is important to consult with a healthcare professional, such as a podiatrist, to determine the most appropriate treatment plan for your specific case of Morton's neuroma.