Morton's neuroma
What is it?
Morton's neuroma is a condition in which fibrous tissue forms around a nerve in your foot, compressing and irritating the nerve. It can eventually lead to permanent nerve damage. The affected nerve is usually one at the base of your third and fourth toes.
Symptoms
You may have the following symptoms if you have Morton's neuroma:
- pain in your foot – you may have sudden attacks of pain, with long periods between attacks when you don't feel any symptoms
- numbness
- an abnormal sensation in your foot, such as burning or prickling
- swelling on your foot around the affected nerve
Your symptoms can become worse as the neuroma gets bigger and the damage to the nerve becomes permanent.
Causes
Morton's neuroma can develop because of irritation and stress to the nerve in your foot over a long period of time. Repeated irritation to the ball of your feet, such as during running, can lead to a neuroma developing. Turning your foot or toe upward too much, which can also happen during running, can also increase your risk of developing a neuroma.
Another common cause of Morton's neuroma is wearing shoes that are too tight or that don't fit very well.
If you have tight calf muscles, or tend to roll your foot inwards too much (overpronation), you may also be more likely to develop this condition.
Treatment
Your GP may refer you to a podiatrist or physiotherapist for treatment of Morton's neuroma, or you can book to see one privately.
There are a number of things he or she may suggest:
- wearing a felt or gel pad in your shoe, to keep the arch of your foot elevated – this can help to prevent the nerve from being compressed and irritated
- using a cold compress, such as ice or a bag of frozen peas, wrapped in a towel, until the swelling goes down (don't apply ice directly to your skin as it can damage your skin)
- orthotics (a special insole worn in your shoe) to provide support and correct overpronation
- deep tissue massage
- stretching exercises
- foot strengthening exercises
You can take over-the-counter painkillers, such as ibuprofen, to help reduce pain and inflammation. Always read the patient information leaflet that comes with your medicine.
If these treatments don't work, you may be given a steroid injection in your foot to reduce pain and inflammation. Occasionally, surgery may be needed to remove or release the affected nerve. Your GP will refer you to an orthopaedic surgeon if he or she thinks this is necessary.
Do
- Wear soft-soled shoes with a low heel and plenty of room for your toes.
- See your GP, podiatrist or physiotherapist as soon as you notice symptoms – the earlier the problem is diagnosed, the less likely you are to need surgery.
Don't
- Wear narrow, tight or high-heeled shoes as these can aggravate symptoms.
- Continue with activities such as running that put repeated pressure on the neuroma.
Peer reviewed by Ann–Marie O'Connor, Bupa Sports Medicine podiatrist
Publication date: June 2009
