A Morton’s neuroma occurs when the sensory nerves of the ball of the foot are pinched and inflamed. Morton’s neuroma can occur between the second and third toe, or the third and forth toe. The most common symptom of a Morton’s neuroma is pain in the ball of the foot, often extending into the toes, to the top or onto the bottom of the foot. The “neuroma” is not outwardly palpable (you can’t feel a bump). Often people complain of numbness and/or tingling of one or both of the affected toes. Also people may feel as if a stone is in their shoe or that their sock is wadded up.
Causes of a Morton’s neuroma are typically tight, improperly fitted shoes, or conditions affecting the joints or “knuckles” adjacent to the nerve. Anything that causes pressure upon the nerve will irritate the nerve and cause symptoms and eventually scarring around the nerve.
Treatment of Morton’s neuromas is centered around relieving the irritation and pressure around the nerve. This includes changes in footwear. You should avoid high heels and tight shoes; instead wear wider shoes with lower heels, a rigid outer soles and a soft inner sole. This allows the bones to spread out and reduces the pressure on the nerve. Pads (longitudinal metatarsal pads) or inserts (orthotics) also help relieve irritation reducing the pressure on the nerve. Also an injection of cortisone can be used to reduce the swelling and inflammation around the nerve.
If conservative treatment does not relieve your symptoms, your foot and ankle surgeon may discuss surgical treatment options with you. The surgery performed will be to remove the neuroma (neurectomy) or release the tissue around the nerve (neurolysis).