Morton’s neuroma is an entrapment neuropathy characterized by abnormal thickening of the nerve that passes between the two metatarsal bones. The nerve between the third and fourth toe bone is mainly affected. This disorder is also known as intermetatarsal neuroma. Morton’s neuroma is usually one sided. It is seen in middle aged women wearing inappropriate footwear for long period of time.
Morton’s neuroma causes severe sharp burning and shooting pain in the ball of foot. Running or walking fast can worsen pain. Patient has a feeling as if he is standing on a stone or fold of the sock. The condition becomes worse if left untreated. Treatment consists of wearing appropriate and comfortable footwear, ice fomentation to relieve pain, wearing modified shoes, and reducing strenuous running or playing activity.
What Causes Morton’s Neuroma?
No one knows exactly etiology of Morton’s neuroma. But the main suspected reason is wearing high heel footwear which can pressurize the vulnerable area.
The gap between the two heads of metatarsal bones become narrow if a person wears tight and narrow shoes. The nerve passing through this gap will get compressed and irritated. Over a period of time, this will result in thickening and swelling of the nerve.
People born with certain foot abnormalities such as flat foot, hammer toe, high arches, are at risk of developing this condition. Running, tennis and badminton where more pressure is put on third and fourth metatarsal bone tend to increase the risk of developing Morton’s neuroma.
Signs And Symptoms Of Morton’s Neuroma
Morton’s neuroma is extremely painful condition of foot. Onset of this condition is gradual. Person suffering from this condition will experience following symptoms in the area of nerve damage.
- Pain begins in the ball of foot and shoots in the affected toe. Pain is gradual in onset. In the beginning it occurs only when the patient wear tight and narrow fitting shoes which narrows down the gap.
- Pain usually occurs in the third and fourth toe.
- Patient complains of burning and shooting pain which becomes worse on standing or running on the ball of foot.
- Person has feeling as if the sock is folded in the shoes. Patient feels as if he is standing on a stone.
- Pain may be relieved after taking off the shoes and giving rest to the affected foot or avoiding activities that aggravate the condition.
- There is feeling of numbness between the toes.
- Over a period of time pain becomes persistent and chronic which leads to difficulty in walking and standing.
Diagnosis Of Morton’s Neuroma
Morton’s neuroma is diagnosed by the doctor after taking proper case history and examination of the affected area of foot. He will press on the spot between the two metatarsal bones. Often the area is tender to touch. He may recommend X-ray of foot. It will help to eliminate other suspected reasons such as hairline fracture etc.
The definitive diagnosis is made with ultrasound and MRI tests. Usually diagnosis is made from the symptoms and physical examination of the patient. Radiological tests are only necessary if the doctor suspects some other pathology.
Treatment Options For Morton’s Neuroma
Treatment plan will depend on severity and duration of illness. Mild to moderate symptoms of Morton’s neuroma can be easily treated with natural remedies as follows:
- Ice fomentation is effective to reduce pain. Patient has to soak his foot in ice water for few minutes. Repeat it two to three times in a day if there is pain.
- Wear appropriate shoes having wide toe box. Put shock absorbent insoles in the shoes.
- Avoid wearing high heel or tight fitting shoes.
- Give rest to the painful foot. Avoid activities that aggravate pain.
- Massage your foot daily for few minutes.
If pain is severe patient may need a short course of anti inflammatory medicines. Doctors also use steroid and anesthetic injections in the local affected area of the foot. Surgery may be required for patients who do not respond well to the conservative mode of treatment.
Morton’s neuroma is preventable disorder in most cases, if there is no structural abnormality of the foot from birth. Avoid wearing tight and narrow ended shoes. Avoid high heel footwear. Wear enough padding under the ball of foot to reduce pressure while playing sports.