Summary – Morton’s neuroma involves a thickening of the tissue around one of the nerves leading to your toes. This can cause a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb.
Often seen in a wider foot, where footwear compression is common place, and often noted where hallux-abducto valgus is present due to the pressure applied to the lesser metatarsals.
McCrory, P., Bell, S., Bradshaw, C. (2002). Nerve Entrapments of the Lower Leg, Ankle and Foot in Sport. Sports Medicine; 32(6): 371-391
Neal, S., Fields, K. (2010). Peripheral Nerve Entrapment and Injury in the Upper Extremity. American Family Physician; 81(2): 147-155
Evans, A. (2010). The Pocket Podiatry Guide. Churchill Livingstone Elsevier (Sydney NSW).
Diagnostic tip –
Mulder’s sign/click: The pain of the neuroma, as well as a click, can be produced by squeezing the two metatarsal heads together with one hand, while concomitantly putting pressure on the interdigital space with the other hand. With this technique, the pain of the Morton’s neuroma will be localized strictly to the plantar surface of the involved interspace, with paresthesias radiating into the affected toes.
Testing or imagery –
Imaging such as ultrasound and MRI can be extremely effective in diagnosis of a Morton’s neuroma. However use of such imaging may only be necessary to rule out other pathology at the site, as offloading the affected area should aid the nerve pain.
Summary – Morton’s neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. Morton’s neuroma may feel as if you are standing on a pebble in your shoe or on a fold in your sock, or a sharp tingling or burning sensation at the ball of the foot.
High-heeled shoes have been linked to the development of Morton’s neuroma. Many people experience relief by switching to lower heeled shoes with wider toe boxes. Sometimes corticosteroid injections or surgery may be necessary.
Typically, there’s no outward sign of this condition, such as a lump. Instead, you may experience the following symptoms:
• A feeling as if you’re standing on a pebble in your shoe
• A burning pain in the ball of your foot that may radiate into your toes
• Tingling or numbness in your toes
How does this occur? –
Morton’s neuroma occur in response to irritation, pressure or injury to one of the nerves that lead to your toes. Often linked to tight footwear, high heeled footwear and HAV (bunions).
How can this be helped? –
It’s best not to ignore any foot pain that lasts longer than a few days. See your doctor or podiatrist if you experience a burning pain in the ball of your foot that’s not improving, despite changing your footwear and modifying activities that may cause stress to your foot.
Who can help? –
Your podiatrist specialises in localised foot and lower limb pathology and therefore is perfectly placed to manage Morton’s neuroma pain. With use of inserts, padding or a metatarsal dome relief can be achieved by reducing load at the forefoot.