Morton’s neuroma or Morton’s syndrome is a compressed nerve in your forefoot, causing pain between the third and fourth toes.

Symptoms

• Sharp pain in the ball of the foot
• Feeling as if you’re standing on a pebble or a marble
• Numbness and tingling in the affected toes
•Weight-bearing, especially pushing up on your forefoot will make symptoms worse

Causes

Morton’s neuroma develops as a result of continuous irritation and pressure to one of the nerves leading to the toes that can occur due to:

•Ill-fitting shoes which are too tight in the forefoot. This compresses the forefoot and pinches the nerve.

•Activities which involve spinning on the ball of the foot such as golf and tennis.

•Sometimes it is caused by benign tumor on the plantar digital nerves. However, this is not a true neuroma, more of a swelling of the nerves.

•Scar tissue surrounding the nerve from previous or associated injury can also be a factor.

Morton’s Neuroma is most common in these sports:

• Running • Skiing • Snowboarding • Dance

Anatomy

Nerves which transmit messages to the brain from the toes pass between the metatarsal bones in the foot. If the arch in the foot is weak then this can cause the metatarsal bones to pinch the nerve. This causes it to become inflamed.

Once it becomes inflamed, the tissues thicken, making impingement more likely. It’s a vicious circle.This is most likely to happen between the 3rd and 4th metatarsal bones, causing pain, tingling, pins and needles or numbness on the inside of the two toes which the nerve supplies.

Treatment

Treating Morton’s neuroma will be approached differently depending on the severity of your symptoms. Typically, treatment starts with conservative, non-operative methods that include:

•Using shoes with a wider toe box

•Inserting soft insoles with an offloading pad that relieves pressure on the toes

•Corticosteroid injections administered by your orthopedic specialist to relieve pain and inflammation

You can also try these exercises at home to stretch and strengthen the muscles of the foot

If conservative treatment methods fail to relieve symptoms, surgical excision of the neuroma may be recommended.

Surgery typically provides excellent results and relief of symptoms, with a relatively short recovery time.

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