Introduction
Morton’s neuroma is a painful condition affecting the ball of the foot, most commonly between the third and fourth toes. It involves thickening of the tissue around one of the nerves leading to the toes, resulting in pain, tingling, or numbness. This condition can interfere with walking and daily activities. Early recognition and appropriate management are important for relieving symptoms and maintaining foot health.
Causes
Morton’s neuroma develops when the nerve between the toes becomes irritated or compressed. Contributing factors include:
- Improper Footwear: Wearing tight, narrow, or high-heeled shoes that squeeze the toes together.
- Foot Structure: Flat feet, high arches, or bunions can increase pressure on the nerves.
- Repetitive Stress: Activities that involve repetitive impact on the forefoot, such as running or certain sports.
- Toe Deformities: Conditions like hammertoes can alter foot mechanics and increase nerve irritation.
- Injury: Trauma to the forefoot can contribute to nerve thickening.
Symptoms
The main symptoms of Morton’s neuroma include:
- Forefoot Pain: Sharp, burning pain in the ball of the foot, often described as feeling like standing on a pebble.
- Tingling or Numbness: Sensations of tingling, numbness, or a “pins and needles” feeling in the toes.
- Worsening with Activity: Pain that increases with walking, running, or wearing tight shoes.
- Relief with Rest: Symptoms often improve when removing shoes or massaging the foot.
- Toe Discomfort: Discomfort or cramping in the affected toes.
Diagnosis
Diagnosis is based on clinical evaluation and may include:
- Medical History: Review of symptoms, footwear habits, and activity level.
- Physical Examination: Palpation of the forefoot to reproduce symptoms and assess for a palpable mass or “click.”
- Imaging: Ultrasound or MRI may be used to confirm the diagnosis or rule out other causes of forefoot pain.
Treatment Options
Treatment aims to relieve nerve irritation, reduce pain, and restore foot function:
- Footwear Modification: Wearing shoes with a wide toe box, low heels, and good cushioning to reduce pressure on the forefoot.
- Orthotics: Custom or over-the-counter shoe inserts to support the foot and relieve nerve compression.
- Padding: Metatarsal pads can help redistribute pressure away from the affected nerve.
- Activity Modification: Reducing activities that worsen symptoms.
- Pain Relief: Over-the-counter pain relievers such as ibuprofen or acetaminophen.
- Corticosteroid Injections: Injections into the affected area to reduce inflammation and pain.
- Physical Therapy: Exercises to improve foot mechanics and flexibility.
- Surgical Intervention: In severe or persistent cases, surgery may be necessary to remove the thickened nerve tissue.
Prevention
Preventive strategies focus on reducing pressure on the forefoot and maintaining foot health:
- Proper Footwear: Choose shoes that fit well, have a wide toe box, and provide adequate support.
- Avoid High Heels: Limit the use of high-heeled or narrow shoes.
- Foot Care: Address foot pain or changes in foot structure early.
- Regular Exercise: Maintain flexibility and strength in the feet and lower legs.
Takeaway
Morton’s neuroma is a common cause of forefoot pain that can significantly impact daily activities. Early intervention with footwear changes, orthotics, and conservative measures can relieve symptoms and prevent progression. If you experience persistent pain or numbness in the ball of your foot, consult a healthcare provider for evaluation and personalized treatment.