What is Morton’s Neuroma?

Morton’s Neuroma

A neuroma is a thickening of a nerve that can develop in various parts of the body. A Morton’s Neuroma is the most common neuroma found in the foot, it occurs mainly between the third and fourth toes and can also be called a intermetatarsal neuroma.

Risk Factors

  • Footwear especially high heels. Shoes that are too tight or ill-fitting can place increased pressure on your toes and the ball of your foot.
  • Certain types of activity which are generally high impact on the foot e.g. jogging/running may subject your feet to repetitive trauma.
  • Other foot conditions such as bunions, hammertoes, high or flat arches are at higher risk of developing a neuroma.

Signs & Symptoms

Pain is generally felt in the ball of the foot, and can be described as tingling, numb, burning or shooting pain like an electric shock. Can also present as feeling like a wrinkled sock in your shoe and it may radiate up the foot/leg. Pain is made worse by tight footwear and generally relieved by being barefoot. There is generally no signs of swelling or a lump present when dealing with a neuroma so it can be hard to define the area affected.

Diagnosis

In most cases clinical assessment by your podiatrist can lead to diagnosis of a Morton’s neuroma, however in some cases imaging may be needed. This may include an ultrasound to check the intermetatarsal space for signs of a neuroma.

Differential Diagnosis

Soft tissue: fat pad atrophy, bursitis, plantar capsule strain, foreign body reaction, tendon sheath ganglion, plantar plate injury

Skeletal: Stress fracture, arthritic changes, apophysitis

Neurological: Neuropathy, nerve entrapment, nerve sheath tumor

Treatment

Conservative treatment will include; footwear advice (increasing room inside the toe box of your shoes), footwear modification, NSAIDs, padding, orthoses

Other more invasive treatments may be needed if there is no resolve including but not limited to;

  • Corticosteroid injections
  • ESWT (Shockwave therapy)
  • Surgery