What Are the Signs and Symptoms of a Morton’s Neuroma?

Feeling pain, discomfort, and strange sensations in the ball of your foot? Chances are you’ve already labeled it as metatarsalgia, but in order to be able to treat it effectively, you need to get to the root of the problem.

The signs and symptoms of a Morton’s neuroma are subtle, and when you first start noticing them you most likely won’t be able to see anything underneath your foot. You’ll need to pay close attention to how your feet feel in order to pinpoint this condition.

But once you know you’re dealing with a Morton’s neuroma, you can move forward with targeted treatment and improve the symptoms.

Here’s what to look for, and some treatment options to ease your symptoms.

What Is Morton’s Neuroma?

Morton’s neuroma is a painful foot condition that most commonly affects the nerve between your third and fourth toes.

As the soft tissue that surrounds the digital nerve thickens, the metatarsal bones on either side begin placing pressure on it. This irritates the nerve, causing it to become inflamed and leads to discomfort or pain in the ball of your foot.

In most cases, you’ll only develop Morton’s neuroma in one of your feet. In some instances, it can affect the nerve between the second and third toes as well.

What Causes Morton’s Neuroma?

Morton’s neuroma is caused by constant pressure being placed on the digital nerve. This can be caused by several contributing factors, which include:

Shoes

Wearing shoes that are tight, ill-fitting, have a tapered toe box, or have high heels that increase pressure on the forefoot can irritate the nerve.

Over time, the acute pressure on the forefoot can cause a neuroma to develop between the bones of your third and fourth toes.

Overuse

Repeated movement from high-impact sporting activities such as running, walking, basketball, tennis, or hiking for long distances can place excessive strain on the nerve, leading to the formation of the neuroma.

Foot Structure

Both flat feet and high arches can cause biomechanical instability, which places excessive pressure on your forefoot. When you combine this with repeated movement like walking, it can increase your risk of developing a Morton’s neuroma.

There are also foot conditions like bunions and hammertoes that increase your risk of developing a Morton’s neuroma. This is mostly caused by uneven weight distribution that places your forefoot under enormous strain.

Obesity

Your feet carry your entire body weight, distributing it evenly across your foot while absorbing the impact of shock with each step you take.

When you’re overweight, this increases the amount of strain that’s placed on your feet and ankles. Over time, this can cause the muscles and tendons to weaken, placing huge amounts of strain on the foot, causing a neuroma to develop.

It can also increase your risk for developing other foot conditions, like plantar fasciitis.

Morton’s Neuroma Symptoms

The symptoms of Morton’s neuroma develop gradually over time. At first, you may only notice a light tingling feeling between your toes.

As the condition progresses, you’ll start to feel a sharp shooting, stabbing, or burning pain around the ball of your foot or the base of your toes. You may also notice a numbness that radiates into the ball of your foot.

When you go about your daily activities, it will start to feel as though you’re walking with a pebble in your shoe. You’ll also find that the pain and discomfort gets worse when you’re on your feet for an extended time, or wearing tight-fitting or high-heeled shoes.

You’ll find that you get some relief when you remove your shoe and rest your foot.

The symptoms will become more severe and intense as the neuroma becomes larger. You may find that the symptoms last for a few days or even weeks.

It’s important to note that if left untreated, the damage to the digital nerve can become permanent.

This could lead to you experiencing uncomfortable or painful sensations and your doctor may recommend surgery to repair or remove the damaged nerve.

Treatments

Padding

Metatarsal pads—also called met pads—are unobtrusive pads that you place just behind the ball of your foot.

The pad reduces the amount of pressure that’s placed on the ball of your foot by supporting your transverse arch and distributing the load to the shafts of the metatarsal bones.

This also allows your toes to spread more naturally, reducing the pressure on the nerve when you walk, run, or jump. They’re affordable and easy to use.

Ice

Applying ice to the painful area underneath your foot for 15 to 20 minutes, 3 to 4 times a day, can help alleviate pain and reduce inflammation.

To prevent frostbite and skin irritation, make sure to wrap the ice pack in a towel before placing it on your foot.

Inserts or Custom Orthotics

Both inserts and custom orthotics have been shown to be effective in the treatment of Morton’s neuroma.

Inserts for morton’s neuroma will provide a protective layer of cushioning for your forefoot and support the arch of your foot, which will redistribute your body weight evenly across your foot bones.

They also often feature built-in metatarsal support, which helps to lift and spread your metatarsal heads—toe knuckles—reducing the excess pressure and friction that’s placed on the neuroma.

This allows your foot to move naturally, in its correct alignment, and alleviates the symptoms of Morton’s neuroma with every step you take.

Shoe Changes

Start wearing shoes that have a wide toe box, this will allow your toes to spread naturally. This will reduce both the friction and pressure that’s placed on the bones in the forefoot, which can aggravate the nerve.

Make sure that your feet have plenty of space within the shoe to accommodate how your feet swell throughout the day.

The best way to do this is to have at least one finger’s width of space between your foot and the end of the shoe.

There should actually be enough space for one of your fingers to fit nicely and snugly between the heel of your foot and the heel of your shoe. The easiest way to check this is to simply slide a finger down the back of your shoe.

Wear shoes that provide proper arch support for your foot shape as this will help absorb shock, distribute your weight evenly, and reduce the pressure on your forefoot.

Avoid wearing any shoes that are narrow-toed—pointed—or have a heel height of over 3 inches.

Ideally, you should look for a shoe that has a heel height of 1 inch. This won’t place any excess pressure on your forefoot and it reduces the tension on your Achilles tendon.

Maintain a Healthy Weight

Follow a balanced diet and regularly do low-impact exercises. This will help you to shed those excess pounds and maintain a healthy weight.

This will reduce the amount of pressure on your feet and other joints as you go about your day-to-day activities.

Medications

To reduce pain and inflammation, you can use over-the-counter pain medications—nonsteroidal anti-inflammatory drugs—like Ibuprofen.

Injection Therapy

Depending on the severity of your Morton’s neuroma, your doctor may recommend either a corticosteroid injection or an alcohol sclerosing injection to alleviate the symptoms.

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