Morton’s neuroma: Treatment, symptoms, and exercises

Morton’s neuroma is a benign, or non-cancerous, growth of nerve tissue that develops in the foot, usually between the third and fourth toes. It is a common and painful condition.

It is also known as Morton’s metatarsalgia, Morton’s disease, Morton’s neuralgia, Morton metatarsalgia, Morton nerve entrapment, plantar neuroma, and intermetatarsal neuroma.

It is due to a swollen nerve in the ball of the foot, normally between the base of the third and fourth toes.

Fast facts on Morton’s neuroma

Morton’s neuroma involves a growth of nerve tissue, but it is not cancerous.

It causes pain in the ball of the foot.

Surgery is an effective solution, but it is only used if other treatments fail, such as exercises and home remedies.

The exact causes of Morton’s neuroma are still not known, but wearing high heels and playing some sports can contribute.

Treatment

Doctors performing foot surgery
Surgery is an effective treatment for Morton’s neuroma. However, this treatment option is the last resort.

Patients with Morton’s neuroma may need to change their footwear, take painkillers, or have steroid injections. In some cases, surgery may be needed to remove the affected nerve or release the pressure on it.

Treatment depends on several factors, including:

the severity of symptoms

how long they have been present

whether home treatment has been tried

The earlier the condition is diagnosed, the less likely the person is to need surgery.

If symptoms are severe or persistent, and self-help measures do not help, the doctor may recommend:

Corticosteroid injections: A steroid medication that reduces inflammation and pain is injected into the area of the neuroma. Only a limited number of injections are advised, as there may be side effects. These include hypertension (high blood pressure) and weight gain.

Alcohol sclerosing injections: Studies have shown that alcohol injections reduce the size of Morton’s neuromas as well as alleviating pain. Injections are typically administered every 7 to 10 days. For maximum relief, between four and seven injections are usually needed.

Morton’s neuroma surgery

If other therapies have not worked and symptoms persist after 9 to 12 months, it surgery may be advised.

Surgery is usually effective, but it can result in permanent numbness in the affected toes. This is why doctors recommend trying other options first.

Surgery involves either removing the nerve or removing the pressure on the nerve by cutting surrounding ligaments or fibrous tissue.

Two surgical approaches are possible:

Dorsal approach: The surgeon makes an incision on the top of the foot, allowing the patient to walk soon after surgery because the stitches are not on the weight-bearing side of the foot.

Plantar approach: The surgeon makes an incision on the sole of the foot. During recovery, most patients will need to use crutches for about 3 weeks. The resulting scar might make walking uncomfortable. However, the neuroma can be reached easily and removed without cutting any structures.

There is a small risk of infection around the toes after surgery.

A man holding the ball of his foot.
Foot pain, often described as burning, in the ball the foot is the most common symptom of Morton’s neuroma.

Patients experience numbness and pain in the affected area, which is relieved by removing footwear and massaging the foot.

In Morton’s neuroma, the tissue around one of the nerves leading to the toes thickens, causing a sharp, burning pain in the ball of the foot.

Outward signs of Morton’s neuroma, such as a lump, are extremely rare. Morton’s neuroma signs and symptoms usually occur unexpectedly and tend to worsen over time.

The main symptom is pain when the foot bears weight. A shooting pain may affect the adjacent sides of two toes. It may be felt after only a short time of walking.

Sometimes, there may be a dull pain rather than a sharp one. Most commonly, pain is felt between the third and fourth toes. Typically, a patient will suddenly experience pain while walking and will have to stop and remove their shoe.

Other symptoms include:

burning pain, often described as like a “red hot needle,” which can start suddenly while walking

numbness may affect the toes

paresthesia, a tingling, pricking, or numbness with no apparent long-term physical effect, commonly known as pins-and-needles

a sensation that something is inside the ball of the foot.

Many patients describe the sensation as a burning pain in the ball of the foot that often radiates to the toes.

Initially, the pain might become much more apparent when the person wears tight, narrow, or high-heeled shoes, or engages in activities that place pressure on the foot. Symptoms may be continuous and last for days, and even weeks.

Symptoms can become so severe that affected individuals become anxious about walking or even placing their foot on the ground. In some cases, however, the neuroma is symptomless; MRI scans sometimes reveal Morton’s neuroma lesions in patients who have no symptoms at all.

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