Morton’s neuroma, also called Morton’s metatarsalgia and intermetatarsal neuroma, is a condition in which tissue thickens around a plantar nerve near the ball of your foot, creating a painful sensation that feels as if you’re standing on a small rock or an uncomfortable fold in your sock.
People with intermetatarsal neuroma will most commonly feel pain on the ball of their foot between their third and fourth toes (intermetatarsal describes the location of the ball of the foot between the metatarsal bones). Sometimes the sensation feels like you’re standing on something uncomfortable, and sometimes the pain is more of an intense, burning pain at the ball of your foot. Your toes may also experience stinging or numbness. You cannot feel Morton’s neuroma from outside the foot (a lump or bump, for example). All of the symptoms are internal.
Generally, symptoms of Morton’s neuroma build gradually, beginning with occasional foot pain that goes away with massage and wearing different shoes, building to intense foot pain that is permanent, as the nerve damage that occurs is irreversible.
Pressure, irritation, compression and injury to the nerves in the bottom of the foot can cause Morton’s neuroma. The most common cause of nerve damage to this part of the foot is wearing high-heeled shoes, shoes with a narrow toe box or shoes that squeeze your feet tight. Other causes include high-impact athletic injuries and foot deformities like bunions, hammertoes, high arches and flat feet, which can irritate the nerves in the foot and eventually cause permanent damage.
While it may be tempting to diagnose yourself after looking at sites like WebMD, Medline Plus and Medscape, any foot pain you’re experiencing should be examined by a podiatrist or other health care specialist. Early diagnosis of intermetatarsal neuroma can help slow its progression and lessen the need for invasive treatments.
After diagnosis, your doctor may recommend several treatment options, including arch padding that takes pressure off of the metatarsals, ice, orthotic devices, nonsteroidal anti-inflammatory drugs (NSAIDs), and injection therapy. If these treatment options are non-responsive, then your doctor may suggest surgical options such as a neuroctomy, which is partial or complete removal of the nerve. However, organizations like the National Health Service (NHS) and the American Academy of Orthopaedic Surgeons (AAOS) strongly advise that when it comes to neuromas, patients try non-invasive treatment options first.
