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Morton’s Neuroma is a common condition affecting the nerves in the forefoot, most commonly the nerve that runs between the third and fourth toes. A neuroma is a benign tumour of a nerve.
Morton’s neuroma is not actually a tumour, but a thickening of the tissue that surrounds the digital nerve leading to the toes. It occurs as the nerve passes under the ligament connecting the toe bones (metatarsals) in the forefoot. This thickening of the nerve leads to sensitivity and pain.
Causes of Morton’s neuroma
The exact cause of Morton’s neuroma is not known, but it is thought to be related to repetitive stress or irritation of the nerve. Factors that may increase the risk of developing Morton’s neuroma include wearing tight or high-heeled shoes, having flat feet or high arches, or participating in high-impact activities such as running.
The incidence of Morton’s neuroma is eight to ten times greater in women than in men and is most common in middle age.
Symptoms of Morton’s neuroma
Normally, there are no outward signs. Burning pain in the ball of the foot that may radiate into the toes is a common symptom. The pain generally intensifies with activity or wearing shoes. Night pain is rare. There may also be numbness in the toes, or an unpleasant feeling in the toes. High-heeled shoes and tight, narrow shoes can aggravate this condition by compressing the toe bones and pinching the nerve.
Diagnosing Morton’s neuroma
To diagnose Morton’s neuroma, Dr Singh will typically begin with a physical examination and medical history. During the physical exam, he will look for signs of inflammation, tenderness, or a mass in the affected area. Dr Singh may also perform certain manoeuvres, such as squeezing your foot or manipulating the toes, to elicit symptoms.
Imaging tests, such as X-rays or MRI, may also be used to help diagnose Morton’s neuroma and rule out other conditions, such as stress fractures or arthritis.
In some cases, nerve conduction studies or electromyography (EMG) may be performed to evaluate the function of the affected nerve and rule out other nerve-related conditions.
Treatment for Morton’s neuroma
Early diagnosis and treatment of Morton’s neuroma can help prevent the condition from worsening and improve the chances of a successful outcome. Treatment options depend on the severity of symptoms and may include:
- Footwear modifications: Wearing shoes with a wider toe box or lower heels can help relieve pressure on the affected nerve.
- Orthotics: Custom shoe inserts can help support the foot and reduce pressure on the nerve.
- Injection therapy: Steroid injections into the affected area can help reduce inflammation and alleviate pain.
- Physiotherapy: Stretching and strengthening exercises can help improve foot mechanics and relieve symptoms.
- Surgery: In severe cases where other treatments have not been effective, surgical removal of the affected nerve may be necessary.
These factors, including treatment options can all be discussed with you in consultation with Dr Singh.
