Morton’s Neuroma is the most common neuroma in the foot. It occurs in the forefoot area (the ball of the foot) at the base of the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma. “Intermetatarsal” describes its location in the ball of the foot between the metatarsal bones (the bones extending from the toes to the midfoot). A neuroma is a thickening, or enlargement, of the nerve as a result of compression or irritation of the nerve. Compression and irritation creates swelling of the nerve, which can eventually lead to permanent nerve damage.
Pronation of the foot can cause the metatarsal heads to rotate slightly and pinch the nerve running between the metatarsal heads. This chronic pinching can make the nerve sheath enlarge. As it enlarges it than becomes more squeezed and increasingly troublesome. Tight shoes, shoes with little room for the forefoot, pointy toeboxes can all make this problem more painful. Walking barefoot may also be painful, since the foot may be functioning in an over-pronated position.
Symptoms typically include pain, often with pins and needles on one side of a toe and the adjacent side of the next toe. Pain is made worse by forefoot weight bearing and can also be reproduced by squeezing the forefoot to further compress the nerve. Pressing in between the third and forth metatarsals for example with a pen can also trigger symptoms.
Your podiatric physician will begin by taking a history of your problem. Assist him or her by describing your condition as well as you can. Keep track of when the symptoms started and how, any changes you?ve noted (whether the pain has gotten worse, or whether other symptoms have appeared as well, etc.). If you?ve noticed that certain activities or footwear make things worse or bring about additional symptoms, be sure to mention that. If you work in specific footwear, or if you participate in any certain sports, bring the shoes you use. Your doctor may be able to learn quite a lot about your condition that way!
Non Surgical Treatment
Wearing shoes that provide enough room in the toe box is also the first step in treating Morton?s neuroma. For instant relief when pain flares up, try taking your shoes off and rubbing the area. The nerve can get trapped below the ligament, and rubbing can move it back to its natural position. Your doctor or a foot-care specialist may recommend lower heels and metatarsal pads. These pads provide cushioning under your neuroma and better arch support to redistribute your weight. If you keep pressure off the toes and wear wide enough shoes, the problem may gradually disappear.
Surgery. This is the last and most permanent course of action. This surgery is used as a last resort as it often comes with a series of side affects including the risk of making the pain worse. This surgery can be performed by Orthopedic surgeons as well as Podiatric surgeons.