Neuromas

Morton's Neuroma

Morton's neuroma is a thickening of nerve tissue between the toes. It commonly affects the nerve that travels between the third and fourth toes. It can also affect the nerves between the second and third digits.

Causes

Morton's neuroma is more common in women than men.

The exact cause is unknown. However, some experts believe the following may play a role in the development of this condition:

Abnormal positioning of toes
Flat feet
Forefoot problems, including bunions and hammer toes
High foot arches
Tight shoes and high heels

Symptoms

Symptoms of Morton's neuroma include:

Tingling in the space between the second and third or third and fourth toes
Toe cramping
Sharp, shooting, or burning pains in the ball of your foot (and sometimes toes)
Pain that increases when wearing shoes or pressing on the area
Pain that gets worse over time

In rare cases, nerve pain occurs in the space between the second and third toes. This is not a common form of Morton's neuroma, but treatment is similar.

Exams and Tests

A foot x-ray may be done to rule out bone problems. MRI or high-resolution ultrasound can successfully diagnose Morton's neuroma. Diagnostic ultrasound is very effective in evaluating a Morton’s neuroma.

Nerve testing (electromyography) cannot definitely diagnose Morton's neuroma, but may be used to rule out conditions that cause similar symptoms.

Treatment

Nonsurgical treatment is tried first. Your doctor may recommend any of the following:

Padding and taping the toe area
Shoe inserts
Changes to footwear (for example, shoes with wider toe boxes)
Anti-inflammatory medicines taken by mouth or injected into the toe area
Nerve blocking medicines injected into the toe area
Other painkillers
Physical therapy

Anti-inflammatories and painkillers are not recommended for long-term treatment.

In some cases, surgery may be needed to remove the thickened tissue. This can help relieve pain and improve foot function. Numbness after surgery is permanent, but should not be painful.