What is Morton's Neuroma?

Morton’s neuroma is named after Dr Morton who first described this condition in 1876. It is sometimes called Morton’s metatarsalgia or interdigital neuroma. 

The nerve that runs between the 3rd and 4th metatarsals in the feet are most often affected. But it can affect other intermetatarsal spaces too. Morton's neuroma is a thickening of the plantar digital nerve.

Although it is called Morton’s neuroma, it's actually not a neuroma. A neuroma is a non cancerous(benign) tumour that grows from the fibrous covering of the nerve. 

There are various causes of a neuroma 

It can be caused due to long standing compression, rubbing or the nerve being stretched. 

As the space between the 2nd and 3rd metatarsals and 3rd and 4th metatarsals is narrower, they are more likely to become compressed and irritated.  Women are more affected as a result of wearing high heels or in both men and women who wear narrow fitting footwear that increases this compression of the nerve. Hence choosing the right footwear is very important.

A person's foot shape can increase the likelihood of developing a Morton’s neuroma. For example someone with a high arch or instep has increased pressure across the ball of their feet and hence more compression to the nerve.

If a person’s foot is out of alignment, which may cause a change in gait or even the way they stand, this will cause additional pressure to the area. Sometimes, other problems can contribute to the compression of the nerve, such as fatty lump growth or formation of a fluid filled sac that can form around the joint, and inflammation in the joints.

The main symptoms of a Morton’s neuroma is a shooting, stabbing or burning pain in the ball of the feet and into the affected toes.  Some people just have toe pain with numbness between the affected toes, and some describe it as feeling like walking on a stone.  

The symptoms can vary over a number of years, from a couple of attacks of pain in a week and then nothing for a year. Others may have regular and persistent pain.

There are various treatments for Morton’s neuroma. The podiatrist will investigate if the thickening has occurred and isolate the nerve. The cause of your Morton’s neuroma will then be identified and a treatment plan implemented. 

If the podiatrists feels it necessary, a referral for a surgical procedure to remove the affected tissues can be made.