Morton’s neuroma is a very common problem that our podiatrists treat a lot of in clinic. However few people have heard of it, or know the symptoms. Morton’s neuroma causes pain in the ball of the foot and into the toes. It can cause shooting, burning pain or numbness near the toes or up the top of the foot. It most commonly causes discomfort of the 2nd and 3rd or 3rd and 4th toes, however can effect almost any toes. Sometimes it is called metatarsalgia, or Morton’s plantar neuroma. In the Canberra region Morton’s neuroma is more common in females, this can be due to females wearing tighter foot wear such as court shoes and high heels.
The pain is caused by impingement of the interdigital branch of the medial plantar nerve against the transverse metatarsal ligament. Morton’s neuroma is sometimes associated with intermetatarsal bursitis and this can be a consequential finding on ultrasound investigation. Although both conditions can be seen on ultrasound, treatment is primarily based on clinical findings and pain descriptors.
Compression (and associated pain) increases with pressure across the forefoot; for example by wearing shoes too narrow in the toe-box. This pressure is also increased when wearing high heels. Wearing shoes with less than 1.5cm heel with adequate room and flexibility in the toe-box can help reduce the symptoms. Your podiatrist can help you with footwear assessment and recommendations, to ensure footwear is not contributing to your pain.
In some cases, the way our foot interacts with the ground can increase friction or instability of the foot can cause the pain and symptoms will persist until this is addressed. Controlling or altering the way the foot moves when walking can be achieved with supportive footwear or with custom functional orthoses that go into shoes to change how the foot moves. You podiatrist can assess your gait, identify any problems and make recommendations based on their findings.