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Morton's Neuroma (Interdigital Neuroma; Intermetatarsal Neuroma)

Mortons Neuroma is a common foot condition that results in swelling and scarring of the digital nerve and usually affects the nerves that run between the third and fourth or second and third toes. Mortons Neuroma is caused by the irritation of the common intermetatarsal nerve as it passes through the forefoot to the toes. Morton's Neuroma is an enlarged nerve.

What exactly is Mortons Neuroma ?

Mortons Neuroma is not really a "nerve tumor" as one might guess from the term, it is really a thickening of the tissue surrounding nerve leading to the toes. The swelling of the nerve is often the cause of symptoms. Mortons Neuroma is an irritation and entrapment of a nerve from the ligament lying above it. To get the clear meaning of the term Morton's Neuroma, let us understand its root meaning. Neuroma is made of two words - Neuro and Oma. Neuro, of course, relates to the nervous system. Oma is the Latin term that defines a tumor or swelling that is of primary origin. Put the terms together and what is described is a tumor or swelling of a peripheral nerve.

Causes of Mortons Neuroma ?

Mortons Neuroma is caused by the irritation of the common intermetatarsal nerve as it passes through the forefoot to the toes. Morton's neuroma is an inflammation caused by a buildup of fibrous tissue on the outer coating of nerves running to the toes. This fibrous buildup is a reaction to the irritation resulting from nearby bones and ligaments rubbing against the nerves. This irritation can be caused by -

Wearing very tight shoes
Trauma to the foot caused by an injury (such as a sprain or fracture)
Wearing shoes that have high heels
Repetitive trauma to the foot (such as from sports activities like tennis, basketball, and running)

Mortons Neuroma is more common in women than men, possibly because women wear confining shoes more often. High heels cause more weight to be transferred to the front of the foot and tight toe boxes create lateral compression.

Signs and Symptom of Morton's Neuroma

The common symptom of Morton's neuroma are as follows -

Localized pain in the third interspace between the third and fourth toes.
Pain that increased with the time a person spent on their feet, particularly in high heels
A sensation of walking on something, such as a bunched up sock
Burning, pain, tingling, and numbness often shooting into the toes
A dull achy sensation in the forefoot, usually between the 3rd and 4th toes
Pain that decreased once a person got off their feet. It can be sharp or dull, and is worsened by wearing shoes and by walking
A snapping sensation or electrical shock sensation
Pain usually is less severe when the foot is not bearing weight.

Morton's Neuroma Treatment

The first and foremost treatement of Mortons neuroma demands - good supporting shoes which have a wide toe box and a low heel. Here are some methods for treating Morton's Neuroma that can be followed -

1. The initial treatment for Morton's Neuroma consists of padding and taping to disperse weight away from the neuroma.

2. Pads for the weight-bearing part of the foot may help relieve the pressure on the nerve.

3. An injection of local anesthetic to relieve pain and a corticosteroid to reduce inflammation may be administered.

4. Wearing padding in the shoes and/or between the toes and wearing shoe inserts to correct a mechanical abnormality of the foot.

5. Metatarsal pads are an important tool for patients with Morton neuroma symptoms. A metatarsal pad lifts and separates the metatarsal bones thereby decreasing the wear on the intermetatarsal nerve.

6. Injections of cortisone are helpful in treating mortons neuroma. Cortisone does not change the fact that the common intermetatarsal nerve is prone to become entrapped, but it can reduce the painful inflammation in the nerve.

7. When pain occurs it can be alleviated by removing the shoes and applying digital pressure to the painful area on the sole of the foot.

8. Cold ice-pack compresses can be useful in reducing any swelling in morton's neuroma.

Mortons Neuroma Surgery -

Conservative treatment does not work for most patients and minor surgery usually is necessary. If the condition persists, professional treatment by a State Registered Chiropodist / Podiatrist is recommended. They will be able to give you advice and can offer many treatments for this condition. For the long term treatment of this condition, and should conservative measures fail, then surgical excision can be required.

Note: The following information on Morton's Neuroma does not constitute the practice of medicine and is offered as an educational aid.

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