What is Morton's Neuroma? Causes, Symptoms, Diagnosis & Treatment.

What is Morton's Neuroma? Causes, Symptoms, Diagnosis & Treatment

A Morton's Neuroma is a painful condition that affects the ball of your foot, commonly between the third and fourth toes. There may be a thickening of the nerve or nerves with the frequent development of fluid filled sacs next to the nerve or nerves. This leads to a thickening of the tissue around one of the nerves leading to your toes, which causes numbness, stinging, or a sharp burning pain in the aforementioned area. Due to the development of fluid filled sacs Morton’s Neuroma is often described as a “Neuroma Bursa Complex”.

Morton's Neuroma

Causes

The cause of a Morton’s Neuroma is primarily due to an irritation and/or impingement of the nerves involved. This causes a thickening of the tissue, which leads to the symptoms listed in the next section. There are three common risk factors that often contribute to a Morton's Neuroma.

  1. Footwear. Some shoes, such as high-heels or shoes that are tight, place pressure on your toes and the ball of your foot. 

  2. Sports. Not all sports, but high-impact sports that heavily rely on jogging and running(such as AFL and soccer, may subject feet to trauma. Morton's Neuroma can also be brought on spurred by tight sport shoes that put pressure on the toes such as those used during snow skiing or rock climbing.

  3. Foot deformities. People with bunions, hammertoes, high arches or flatfeet are at higher risk of developing Morton's Neuroma. 

Symptoms 

  • Swelling, often described as a feeling of a pebble in the foot. 

  • Sharp stinging sensation. 

  • Burning pain in the foot and/or toes. 

  • Numbness of the toes. 

  • Numbness in the toes which is worse with sporting activities. 

Diagnosis

In most instances one of our Podiatrists can provide a clinical assessment and provisional diagnosis based on your clinical examination and history.  To diagnose whether or not you have Morton's Neuroma, your Podiatrist will press on your foot to feel for a mass or tender spot (the “invisible pebble” you may have been feeling). This is an initial test that might be followed up by an x-ray, ultrasound, or with an MRI.   

The x-ray will rule out other possible cases of the pain such as a stress fracture. The ultrasound will reveal any soft tissue abnormalities (which is what a Morton's Neuroma is), while the MRI will help paint an accurate  picture of the soft tissues if required. 

Treatment

The treatment your Podiatrist recommends will be highly personalised and depend on your experience with the Morton's Neuroma.

Physical Therapy 

More often than not, we’ll try to implement conservative treatments first. 

  • Taping/padding. 

  • Stretching and strengthening. 

  • Footwear modifications. 

  • Orthotics, commonly called arch supports and foot pads that fit inside your shoe reduce pressure on the nerve.  

  • In addition to these treatments, you may find that removing your shoe and rubbing your foot helps relieve the pain if you’re on the go. 

Surgery 

  • Oral Anti-inflammatory drugs. 

  • Ultrasound guided cortisone injections. 

  • Radiofrequency ablation. 

  • Removal of the nerve.  

 Normally surgical intervention is reserved for very persistent and severe cases and while surgery is usually successful, there are risks and it is better to have the problem managed with the above measures. 

Book a consult

If you’ve been experiencing pain and discomfort like the Morton's Neuroma symptoms we’ve described, don’t ignore the pain any longer. Visit The Perth Podiatrists as soon as possible so we can provide a tailored treatment plan that will get you back to doing the activities you love. Book online here.

Gregory McCluney