What is a Morton’s Neuroma?

A neuroma is a thickening or enlargement of the tissue surrounding a nerve, most commonly occurring between the third and fourth toes. It develops as a fibrous growth in reaction to chronic irritation and compression on the nerve bundle.

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Causes and Contributing Factors

The irritation and compression that cause a neuroma are typically mechanical, often related to lifestyle:

  • Footwear: Wearing narrow, high-heeled, or pointy-toed shoes forces the toes together, squeezing the nerve between the metatarsal bones.
  • Foot Biomechanics: Abnormal motion, such as overpronation, can increase stress on the forefoot and nerve.
  • Trauma: A direct injury to the ball of the foot.
  • Repetitive Stress: High-impact activities that put constant pressure on the forefoot.

Symptoms of Nerve Entrapment

The pain is often described as intense and sharp, unlike muscle or bone pain, and is treated at our Mercy Office:

  • Sharp, Burning Pain: Pain in the ball of the foot, often radiating into the toes.
  • Tingling and Numbness: “Pins and needles” sensation or a complete lack of feeling in the affected toes.
  • “Pebble” Sensation: The feeling of walking on a marble, stone, or wrinkled sock inside the shoe.

Treatment Options from Conservative to Surgical

Treatment aims to reduce inflammation, decompress the nerve, and ultimately stop the painful irritation.

  • Conservative Treatment:
    • Footwear Modification: Switching to shoes with a wider toe box.
    • Custom Orthotics: Using prescription orthotics with a built-in metatarsal pad to separate the bones and reduce nerve compression.
    • Injections: Corticosteroid or Alcohol (Sclerosing) Injections to reduce inflammation or chemically destroy the nerve.
  • Surgical Excision (Neurectomy): If conservative measures fail, surgical removal of the neuroma is highly effective and offers a permanent solution to chronic pain, performed by Foot Centers of Maryland.