Causes of Morton’s neuroma

The common digital plantar nerve runs between the metatarsal bones and under the transverse intermetatarsal ligament. The anatomical location of the nerve makes it particularly vulnerable to trauma, stretching and compression. Overtime, the tissue surrounding the nerve may become thickened and inflamed. Improper footwear (ie: tight shoes and high heels), high impact activity, abnormal foot biomechanics and joint hypermobility can increase pressure in the ball of the foot and contribute to the development of a Morton’s neuroma.

Morton’s Neuroma symptoms

People with this condition may experience:
– Burning sensation in the ball of the foot
– A sudden pain that comes and goes as quickly as it appears, like a spasm
– Numbness and shooting pain in the toes
– The feeling of walking on a pebble

Diagnosis

At Shellharbour Podiatry we can often diagnose a Morton’s neuroma through a thorough history in combination with clinical assessment.
Your podiatrist may assess the web spaces and compress the toes to reproduce the symptoms. Sometimes, you can hear an audible click of the nerve as your podiatrist squeezes the ball of your foot. Morton’s neuroma is often demonstrated on ultrasound well so we may refer you for scans to confirm our diagnosis or rule out other conditions. 

How to treat Morton's neuroma

In the majority of cases, Morton’s neuroma can be treated non operatively. The podiatrists at Shellharbour Podiatry will manage the condition with the aim of reducing the load and compressive forces at the intermetatarsal nerve. This may involve:

– Rest, ice, anti-inflammatories
– Activity modification, especially a reduction in activities which increase forefoot load
– Footwear modifications (eg. wider fitting shoes, flatter sole)
– Metatarsal devices to open up the space between the metatarsal heads and offload the neuroma
– Orthotics to address any biomechanical issues that may be contributing to abnormal forefoot compensation
– Injection therapy with local anaesthetic and/or cortisone for more severe or chronic cases not responding to the above treatment