Minimizing Morton’s Neuroma

You feel pain in the ball of your foot. It feels like a tiny piece of coal stuck in your shoe. It seems to derive from the area between your third and fourth toes. You could have Morton’s neuroma.

Morton’s neuroma is a swelling of the nerve between the bones at the base of the toes in the ball of the foot. The pain it causes usually is one spot. It can feel like you have a pebble in your shoe. Once the nerve starts to swell, the nearby bones and ligaments put pressure on the nerves, worsening the irritation and inflammation.

A neuroma usually occurs between the bones of the third and fourth toes. It causes aching pain, a burning sensation, and numbness and tingling in the toes.

Morton’s neuroma is much more common in women than men. In most cases, high-heeled, narrow toe shoes are to blame. High heels can shift the foot bones in an abnormal position and put pressure on the ball of the foot. This causes the foot bones to put pressure on the nerve and that increases the risk that a neuroma will form. Once it forms, the same pressure from bones makes it hurt.

Less often, physical activities that stress the feet (such as running or racquet sports) can cause a Morton’s neuroma. You can temporarily relieve the pain by taking off your shoes, flexing your toes and rubbing your feet. The nerve can get trapped below the ligament, and rubbing can move it back to its natural position.

Other foot causes can be confused with Morton’s neuroma. A wart on the ball of the foot can cause pain, for example. So can inflammation of a sheet of tissue called fascia beneath the skin on the underside of the foot. Inflammation of tissue around the joint (capsulitis or bursitis), or inflammation of one of the foot bones can also cause pain. A doctor makes the diagnosis of Morton’s neuroma by pushing directly on the spot between the third and fourth toes where it forms.

The best way to prevent Morton’s neuroma is to wear shoes with wide toe boxes. Tight, pointed shoes squeeze bones, ligaments, muscles and nerves. High heels may worsen the problem by shifting your weight forward. Over time, this combination can cause the nerves to swell and become painful.

Wearing shoes that provide enough room in the toe box is also the first step in treating Morton’s neuroma. Your doctor or foot specialist may recommend lower heels and metatarsal pads. These pads provide cushioning under your neuroma and better arch support to redistribute your weight. Custom shoe inserts will help correct structural problems and distribute the pressure more evenly.

If you’re in severe pain, your doctor may give you an injection of a local anesthetic combined with a corticosteroid to relieve the inflammation and pain. If you keep pressure off your toes and wear wide enough shoes, the problem may gradually disappear on its own.

For severe or persistent pain, you may need surgery to remove the neuroma. Surgery can remove the neuroma or create a wider space for the affected nerve to travel through. Once the nerve is gone, you permanently lose feeling in the affected area.

One alternative to surgery is to undergo neurolysis injections. These use chemical agents to block pain signals. Another alternative is to take a prescription pain reliever that alleviates nerve pain.

Morton’s neuroma can be easily treated, so contact your health provider right away. With the right treatment options, you can resume an active and pain-free existence as soon as possible. So don’t suffer unnecessarily in silence.