A Morton's neuroma of the foot is a growth of the tissue that can surround a small nerve that innervates the toes. The digital nerves that are most frequently affected by this are between the third and fourth toes, and develop secondary to trauma, chronic irritation, or excessive pressure. Possibly for these reasons, neuromas are more commonly found in women than men.
Patient’s typically complain of the feeling of 'walking on a marble', and may even have burning pain or even numbness that radiates to the toes. Pain can be worse with certain tight shoe wear or high heels, but is almost always associated with standing and walking and not at rest when off your feet. Rarely, there could be deformity to the toes with spreading of the toes apart by the neuroma.
People can also experience nerve pain and inflammation, or neuritis, to the foot due to other reasons: blunt/sharp trauma to a nerve, stretching of a nerve, medications, or other health problems such as diabetes causing Charcot foot. Neuritis can be very difficult to treat, depending on the underlying reason, but medications including anti-inflammatories and ‘nerve-pain medications’ as well as physical therapy focusing on de-sensitization modalities, are often a good start.
Diagnosis of a Morton’s neuroma is commonly made by the patient’s history and physical examination. An ultrasound or MRI can confirm the diagnosis.
Treatment should start with a change in shoe wear as well as activity, that may aggravate the neuroma. Orthotics can also be used, something that utilizes a metatarsal bump or pad, that may separate the bones and prevent the ‘pinching’ of the neuroma. Next, a steroid injection can be done to decrease the swelling and inflammation of the nerve, and may actually rid of the neuroma.
Conservative treatment is successful over 80% of the time, but if it fails, surgery to resect the neuroma can be done. This is a relatively simple procedure with a short recovery period.