Morton's Neuroma
Overview
Morton’s neuroma is a growth or benign tumor that affects the ball of your foot. It is commonly located in the space between your third and fourth toe, which is why it is also known as an intermetatarsal neuroma or intermetatarsal space neuroma. The neuroma entraps the affected nerve, which is what causes the symptoms that characterize this condition.
The exact mechanism that leads to Morton’s neuroma isn’t known. Experts believe that the most likely cause is compression of the plantar nerve by the transverse metatarsal ligament. Over time, this compression leads to an abnormal thickening of the nerve and permanent nerve damage.
Morton’s neuroma is more common amongst middle-aged patients. Women between the ages of 45 and 50 years old are more likely to develop this condition.
Certain risk factors can increase your likelihood of suffering from Morton’s neuroma. These risk factors include:
- Excessive calf tightness
- Flat feet
- Foot overload
- Tight, narrow shoes
- Bunions
- Hammer toes
- Activities that place pressure on the ball of the foot, such as running and tennis
- Activities that require tight shoes, such as ballet
Diagnosis
Treatment
The treatment for Morton’s neuroma is usually very simple. Many patients experience instant relief once they remove their shoes. Your podiatrist will probably start out with a more conservative treatment plan and only move onto more aggressive measures if needed.
Conservative measures include:
- Wearing supportive shoes that don’t feature a narrow toe box
- Over-the-counter anti-inflammatory medications, such as ibuprofen or naproxen
- Over-the-counter or custom orthotics or shoe inserts
- Massaging your foot
- Applying cold packs to the ball of your foot
- Rest
- Exercises that help stretch and loosen the affected ligaments, muscles, and tendons
Brent Goddard - Podiatrist, discusses treatment options for Metatarsalgia and Morton's Neuroma and what your treatment options are.
Surgery
- Neurectomy: this procedure involves removing the affected nerve tissue. Scar tissue can form after the surgery, leading to a stump neuroma which can cause symptoms that mimic those of the original neuroma. This surgery can also result in excessive splaying of the third and fourth toes.
- Cryogenic neuroablation: during this surgery, neuronal axons are destroyed by freezing them. Destroying the axons stops them from carrying painful impulses. This surgery doesn't carry the risk of developing a stump neuroma.
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