Morton’s Neuroma

Morton’s Neuroma is a pathological condition of the common digital nerve, most frequently between the third and fourth metatarsals (third inter-metatarsal space). The nerve sheath becomes abnormally thickened with fibrous (scar) tissue and the nerve fibres eventually deteriorate.
This common digital nerve runs along the bottom (plantar) surface of the foot and branches to supply sensation to the plantar aspect and tips of the third and fourth toes. Occasionally, the common digital nerves in the second inter-metatarsal space are affected.
Symptoms
• Pain most commonly in the ball of the foot and affecting one or two of the lesser toes (usually the third and fourth)
• Pain can sometimes radiate to the top of the foot
• The pain may can be intermittent in nature – it may disappear as quickly as it came
• Pain is often sharp, burning, or cramping in nature
• Pain may radiate into the tips of the toes or up the foot/ leg
• Aggravated by tight shoes and prolonged weight-bearing
• Removing the shoe often relieved the pain
Cause
• May involve mechanical irritation of the nerve
• Abnormal foot structure or mechanics (for example. flatfeet or excess foot pronation) contributes to irritation of the nerve
• Tight fitting footwear may contribute to the problem
What you can do
• Remove the shoe and massage your forefoot
• Rest the foot
• Wear shoes with a broad forefoot, low heel, and a good arch (e.g.. running or walking shoe)
Treatment

The treatment of a neuroma that occurs between the metatarsals (called a web space or interdigital neuroma) is to decrease the inflammation and pressure on the nerve. This is done by widening the shoe, avoiding a high heel, wearing a pad or orthotic support in the shoe, and occasionally, the use of cortisone injections into the affected area. These treatments are often effective. If these conservative treatments fail to alleviate or eradicate the symptoms, then surgery with removal of the nerve is an option. By removing the nerve, the pain in the front of the foot and in between the toes invariably decreases, although there is numbness in between the toes which is present and which is permanent.