A neuroma is an abnormality of a nerve. Morton’s neuroma is a thickening either of the nerve between the bones behind your toes or of the tissue that surrounds the nerve leading to the toes. If you feel like you are walking on a marble or rock and you have pain in the ball of your foot, you may have Morton’s neuroma.
Morton’s neuroma occurs as the nerve passes under the ligament connecting the metatarsal heads which are the bones right behind your toes. The condition typically develops between the third and fourth toes.
Cause
- Irritation from tight or narrow shoes such as heels
- Trauma
- Excessive pressure
Women are 8 to 10 times more likely to get Morton’s neuroma when compared to men. Females are at much higher risk because the anatomical construction of a female foot is different from a male foot. Female feet are inherently higher and narrower that causes pressure and strain on the toes more than male feet and they are usually smaller than male feet. Additionally more women are likely to wear high-heels or pointed shoes as compared to males.
Symptoms of Morton’s neuroma
- Burning pain in the ball of the foot
- Pain that radiates from the ball of the foot to the toes
- Pain in the ball of the foot that intensifies with activity or wearing shoes, especially tight shoes or heels
- Numbness in the toes
Runners may feel pain as they push off from the starting block. High-heeled shoes, which put the foot in a similar position to the push-off, can also aggravate the condition. Tight, narrow shoes also aggravate this condition by compressing the toe bones and pinching the nerve.
Treatment
Nonsurgical Treatment
Treatment always begins with conservative treatment and includes:
- Changes in footwear: Avoid wearing tight, narrow, high-heeled shoes. Wear wider shoes with lower heels and a soft sole. This enables the bones to spread out and may reduce pressure on the nerve, giving it time to heal. Buying shoes that are one-half inch longer than your longest toe can also be beneficial.
- Orthotics: Custom shoe inserts and pads also help relieve irritation by lifting and separating the bones, reducing the pressure on the nerve.
- Injection: One or more injections of a corticosteroid medication can reduce the swelling and inflammation of the nerve, bringing some relief.
Surgical Treatment
Over 80 percent of people find relief from conservative treatment options for Morton’s neuroma. If conservative treatment fails, your Raleigh Orthopaedic foot and ankle specialist may recommend surgery to cut out a small portion of the nerve or release the tissue around the nerve. This is usually done as an outpatient procedure and requires protection of the foot for a few weeks after surgery.
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