Does it feel like you have a pebble in your shoe between your 3rd and 4th toes?
Perhaps you have occasional shooting or burning pain in the bottom of your foot?
Do your 3rd or 4th toes occasionally sting or feel numb?
Any of these could be symptoms of Morton’s Neuroma, a painful thickening of the tissue around the nerves that lead to your toes.
Morton’s Neuroma is also known as Morton’s metatarsalgia, Morton’s neuralgia, plantar neuroma, or intermetatarsal neuroma. It typically has no outward signs, such as an obvious lump – only discomfort and pain on the bottom forefront of your foot or toes. Technically, a neuroma is a benign tumor of a nerve. Fortunately, a Morton’s neuroma isn’t a true tumor, but simply a thickening of fibrous tissue. If left untreated however, the neuroma can lead to permanent nerve damage.
How Morton’s Neuroma forms
Abnormalities in the anatomy of the foot, aggravated by injury, irritation, or wearing pointy shoes or high heels, compress and irritate the nerve that passes under the ligament connecting the toe bones in the forefoot. In response, the nerve enlarges and develops a nasty lump. It most commonly develops between the 3rd and 4th toes, and appears in women 10 times more often than in men. Those people who have bunions, flat feet, hammer toes, or unusually high arches, are prime candidates for developing Morton’s Neuroma. So are those athletes who perform on courts or hard surfaces – runners will notably feel the pain when they push off from the starting line.
Symptoms of Morton’s Neuroma
- Feeling of having a pebble in your shoe
- Burning or stinging pain and numbness in the area between the 3rd and 4th toes
- Pain intensifies with activity and subsides with rest
- Symptoms rarely appear at night
Causes of Morton’s Neuroma
Abnormality in foot biomechanics, aggravated by:
- High heels, shoes that are too tight, or shoes that don’t fit correctly. This footwear can put pressure on the toes and ball of you foot, aggravating the nerve.
- Sports that put unusual stress on your toes, like rock climbing, or snow skiing, or high impact aerobic sports like running or basketball.
Treatment of Morton’s Neuroma
- Change your footwear. Swap high heels for flats, and wear shoes with a square toe box which will not constrict the movement of your toes. This lets the bones spread out, taking pressure off the nerve, and allowing it to heal.
- Custom orthotics or pads may be worn inside your shoes. A podiatrist at PA Foot and Ankle Associates will customize an orthotic for you which will take pressure off of the sensitive area. This speeds healing by lifting and separating the toes, taking pressure off the nerve.
- Steroidal injections can be used to reduce pain and inflammation in the affected area.
- Over the counter anti inflammatory medicine like advil or aleve can be used to control pain, along with ice and rest.
- If these treatments fail to relieve your symptoms, surgery may be recommended.