Morton’s neuroma is a benign, non-cancerous yet painful condition that usually affects the ball of the foot, the region in between the third and fourth toe. It is also known as intermetatarsal neuroma since the location of the injury is in between the metatarsal bones. The condition also goes by several medical terminologies including Morton’s disease, Morton’s neuralgia, Morton’s metatarsalgia, Morton metatarsalgia, Morton nerve entrapment, and plantar neuroma.

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This painful condition usually involves thickening of the tissues around one of the nerves of sensation between the ends of the metatarsal bones at the base of the toes. The condition occurs due to compression or irritation which eventually causes inflammation or a sharp, burning pain in the ball of your foot making you feel as if there is swollen tissue under your feet, or you are standing on a stone or pebble or if the socks you are wearing is folded under your foot.

Causes

The primary cause of Morton’s neuroma, is actually anything that puts stress on the ball of the foot causing it to compress and get irritated. It may even occur due to injury to the nerve leading up to the nerve causing intense irritation and inflammation.

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Risk Factors

Certain causative factors that increase the chances of Morton’s neuroma  includes:

Gender: Morton’s neuroma is more commonly diagnosed in women than men.

High Heels: Size of heels play a huge role in case of this disease. Shoes having high heels or ones which are too tight leading to compression or the ones which are ill-fitting causing intense pressure on the ball of the foot may aggravate the chances of Morton’s neuroma.

Deformities Of Foot: People who are suffering from conditions like hammertoes, bunions, high arches or flatfeet have high chances of developing Morton’s neuroma. Even an abnormality in the gait can create pressure on the nerve connecting the toes and cause this painful condition.

Certain Sports: Taking part in sports activities like running, jogging, sprint etc which involves creating pressure on the ball of the foot can cause this painful injury. Even ill-fitting shoes wore while ballet dancing, rock climbing or skiing may also make one prone to Morton’s neuroma.

Symptoms

Morton’s neuroma usually doesn’t show up any outward visual symptoms like a lump or external tissue. It is more of an internal injury causing pain. The common signs and symptoms include:

• Tingling or numbing sensation in the toes
• Feeling as if you're standing on a pebble inside your shoe or feeling of a folded layer of sock under the feet
• Intense burning pain in the ball of your foot that may radiate into your toes
• Extreme discomfort while walking in a tight fitted shoe
• Pain easing off when at rest or at night

Complications

Although Morton’s neuroma is a totally treatable condition, if left untreated for a long time, it can lead to complete damage of the nerve of sensation that leads up to the ball of the foot.

Diagnosis And Treatment

On noticing any pain or discomfort while trying to walk, consult a doctor right away.  The doctor usually does a thorough physical check-up by moving your toes or pressing the ball of the foot to look for any signs of pain or the exact location from where the pain exudes and also perform a few diagnostics including:

Imaging techniques like X-rays to rule out pain exuding due to fractures or arthritis, MRI and Ultrasound imaging to analyse any abnormalities in the soft tissue of the foot . The doctor may even perform an electromyography to inspect any damage or problem in the nerves.

Treatment

The available treatment options usually depend upon the severity of the condition and involves simple remedial measures including:

• Massaging with ice
• Adequate rest
• Over-the-counter pain relieving medications
• Changing footwear by opting for flat or proper fitted shoes
• Using foot inserts or foot pads to place inside the shoe for reducing pressure on the ball of the foot
• Weight loss to indirectly reduce the pressure on the foot
• Physical therapy to gradually help stretch and strengthen the foot.

Even after going for the simple remedies, if the pain in the ball of the foot doesn’t subdue, the doctor may opt for one of the following measures:

• Numbing injection
• Steroid injection
• Cold therapy
• Decompression surgery
• Neurectomy (to remove the pain causing nerve as a last resort)