A Morton’s Neuroma is an enlargement of the nerve between the 3rd and 4th toes and metatarsal bones.
Common symptoms of a neuroma include burning pain, tingling, and numbness in one or two of the toes. As the nerve swells, it can be felt as a popping sensation when walking. Pain is intermittent and is aggravated by anything that results in further pinching of the nerve. Removing the shoe and rubbing the ball of the foot often helps to ease the pain.
The diagnosis of a neuroma is usually made by physical examination. Conditions that mimic the pain associated with a neuroma are a stress fracture of the metatarsal, inflammation of the tendons in the bottom of the toes, arthritis of the joint between the metatarsal bone and the toe, or nerve compression or damage further up in the leg or lower back. X-rays are sometimes taken to rule out a possible stress fracture or arthritis.
What we can do to help you solve this problem
We would recommend that you wear a shoe with a wide toe box and to avoid shoes with heels that may put excessive pressure on the ball of your foot. Removing your shoes and massaging the area can also help relieve an acutely painful neuroma.
If simple measures are not helpful in relieving your pain, then we recommend that we see you for treatment. Initially, we will take a complete and thorough history of the problem and perform a complete examination of your foot anatomic structure. Digital x-rays may need to be taken to rule out other problems. We will perform a comprehensive biomechanical analysis of your gait to see how this may play a role in the formation of the neuroma.
We tend to see neuroma formation in people that have a foot type that pronates or flattens excessively. The most effective way to control this pronation is with the use of custom-made orthotics. Orthotics are a special insert made for the shoes to control excessive pronation or flattening of the arch. By stabilizing the foot, pressure is effectively offloaded from the ball of the foot and the neuroma.
Neuromas often respond well to the proper arch support or prescription orthotics. If your neuroma symptoms are mild, we may be able to use a pre-made arch support to control the abnormal flattening of your arch and to remove the strain to the ball of the foot. We carry arch supports in our office that are typically much better than what you will find in the store. Some cases of neuromas may require the use of prescription orthotics. This is a custom-made arch support that is made from a plaster impression or digital scan of your foot and arch. Unlike pre-made arch supports, however, an orthotic completely controls abnormal pronation and strain to the ball of the foot. Learn more about custom orthotics.
It may also be necessary to perform a cortisone injection to help reduce the inflammation associated with the neuroma. A newer treatment that has shown to be effective is sclerosing injections of the nerve with a medical-grade alcohol. Sclerosing treatment consists of a series of injections of the alcohol solution to essentially destroy the nerve tissue in the affected area.
Some neuromas do not respond to conservative treatment and may need to be removed. Surgical excision of the neuroma is a relatively simple procedure that is typically performed in the hospital. Learn more about neuroma surgery.
At Council Bluffs Foot & Ankle Care, our physicians are experts in the treatment of Morton’s neuromas. We will perform a thorough evaluation of your condition and find the treatment that is right for you. Call today to make an appointment.