Morton's Neuroma: causes, symptoms, diagnosis and treatment (2023)

General description

What is Morton's neuroma?

Morton's neuroma affects the forefoot or sole, between the metatarsal bones and the toes. Also called intermetatarsal neuroma. When you have Morton's neuroma, the nerve between the bones in your toes can become swollen and inflamed. You usually feel it on the sole of your foot, between your toes. Neuroma can be painful and make walking difficult.

Getting treatment for Morton's neuroma is important. Neuroma can enlarge without treatment. Nerve damage can become permanent.

Is Morton's neuroma a tumor?

The "neuroma" in Morton's neuroma is a bit misleading. Neuromas are noncancerous (benign) growths found on nerves throughout the body. They involve further growth of nerve tissue.

With Morton's neuroma, there is no growth or tumor. Instead, the existing tissue around the nerve becomes inflamed and enlarged.

Where does Morton's neuroma occur?

Usually, the neuroma occurs between the bones of the third and fourth fingers. These are the two fingers closest to the little finger (finger #5). But Morton's neuroma can also form between the second and third toes.

The condition develops when the nerve is placed under excessive pressure or compression between the fingers. This compression (squeezing) causes inflammation and irritation.

Who gets Morton's neuroma?

You may face an increased risk of developing Morton's neuroma due to:

• foot shape:if you were born withflat cake, high arches, or unusually positioned toes, you may have toe joint instability. This instability can lead to Morton's neuroma.
• Certain medical conditions:Some foot conditions that develop over time can increase your risk of developing Morton's neuroma. Examples includeladybugsyhammer fingers.
• Sports:Sports like running, tennis, and other racquet sports require a lot of pressure on the balls of your feet while running. Athletes are also more likely to injure their foot, which can lead to Morton's neuroma.
• Choice of footwear:High heels (over 2 inches in height) can cause problems. The same goes for tight, narrow or pointed shoes. All of these shoes put extra pressure on the balls of your feet and limit your toe movement.

How common is Morton's neuroma?

About 1 in 3 people have Morton's neuroma. It occurs more often in women than men, probably due to the style of their shoes. Women are 8 to 10 times more likely than men to develop Morton's neuroma.

Symptoms and Causes

What causes Morton's neuroma?

An irritated or damaged nerve between the bones in the toe causes Morton's neuroma. You feel it on your toes. Common causes of the nerve reacting in this way include:

• Being born with a congenital foot problem.
• Putting pressure on the sole of the foot when running during certain sports.
• Wear shoes that prioritize style over support.

What are the symptoms of Morton's neuroma?

You may not see any noticeable signs of Morton's neuroma in your foot. Since it's not a tumor, you won't see a lump, for example. You may feel some pain at first, although it tends to start slowly. At first, you can often improve your symptoms by taking your shoe off and massaging your foot.

The symptoms of Morton's neuroma get worse over time. These symptoms include:

• Sharp, sharp, or burning pain between your toes when you stand up or walk.
• Swelling between the fingers.
• Tingling (pins and needles sensation) and numbness in the foot.
• You feel as if there is a sock piled up or a small stone under the sole of your foot.
• Pain that gets worse when you wear high heels or stand on your toes.

Diagnosis and Tests

How is Morton's neuroma diagnosed?

During an exam, your doctor:

• Look at the feet to see if there is a mass between the toes.
• Press into the spaces between the toe bones to determine the location of pain in the foot.

What tests will a doctor need to diagnose Morton's neuroma?

Most of the time, your doctor can diagnose Morton's neuroma based on your symptoms and a physical exam. An x-ray will not show a neuroma. But it can help rule out other conditions that cause foot pain, such asstress fractureoarthritis. You may also need aultrasoundoMRIto confirm the diagnosis.

Sometimes your provider may recommend aelectromyographyprocedure. This test measures the electrical activity of your nerves and muscles. It can rule out nerve conditions that can cause symptoms like Morton's neuroma.

Management and Treatment

What are the treatments for Morton's neuroma?

Treatment depends on the severity of the neuroma. There are several treatment options, from those that you can do yourself to those that can be done by a healthcare professional. You may need a combination of treatments to get the most relief.

Can I treat Morton's neuroma at home?

These steps may improve your symptoms:

• Wear good shoes:Choose supportive shoes with a wide toe. Shoes with shock-absorbing soles and the right insoles can help. Do not close the top of the shoe too tightly. And avoid shoes that are tight, pointy, or have heels greater than 2 inches.
• Use insoles:Place these over-the-counter pads in your shoe to relieve pressure.
• Use an ice pack:Put an ice pack on your toes to reduce pain and swelling.
• Rest:Try to rest and massage your feet. Avoid sports and other activities that put a lot of pressure on the foot.

What medications can help with Morton's neuroma?

Your provider can recommend medications that can relieve pain and other symptoms.

Medications include:

• steroid injections.
• Alcohol sclerosing injections, in which a provider injects an alcohol solution to reduce nerve pain.
• Nonsteroidal anti-inflammatory drugs(NSAIDs) such as ibuprofen or aspirin, taken by mouth.
• Anti-inflammatory drugs injected into the skin.
• Injection of local anesthetic to numb the nerve and relieve pain.

Can the device treat Morton's neuroma?

Orthotics are custom shoe inserts that can reduce some of the pain from Morton's neuroma. A healthcare professional adjusts the orthosis to the shape of your foot. You wear them in your shoe to relieve pressure on the sore nerve. Metatarsal pads in shoe insoles and removable metatarsal pads can also offload the ball of the foot where you feel pain.

Will I need surgery for Morton's Neuroma?

If medications and other treatments don't work, your doctor may recommend foot surgery. Neurectomy is the most common surgery for Morton's neuroma. The surgeon removes some of the nerve tissue. Surgery can be a successful treatment for Morton's neuroma. However, some people experience permanent numbness in the affected finger.

Surgeons may also recommend using extreme cold, either before the operation or as a stand-alone treatment. This therapy, called cryogenic neuroablation, can help reduce symptoms. It destroys some nerve cells as well as the myelin sheath that covers the nerve. Treatment temperatures reach 94 degrees below zero Fahrenheit (70 degrees below zero Celsius).

Another minimally invasive procedure isradio frequency removal. This procedure uses an electrical current to heat nerve tissue and help with pain. For most people, this procedure helps relieve pain, which can last for six to 12 months or longer.

Prevention

Can Morton's neuroma be prevented?

You can take steps to prevent Morton's neuroma:

• Do not wear tight-fitting or high-heeled shoes for prolonged periods.
• Wear shoes with a wide toe so your toes don't get caught.
• When you are more active, wear athletic shoes with plenty of padding to cushion the soles of your feet.
• Maintain a healthy weight, as extra pounds put more pressure on your foot.
• For athletes, talk to your coach or trainer to discuss appropriate activities to reduce pressure on the foot.

Outlook / Forecast

What is the prognosis for people with Morton's neuroma?

Treatment is effective and can help you get back to a pain-free life. Research has shown that a combination of treatments can give the best result:

• Wear roomy shoes.
• Take nonsteroidal anti-inflammatory drugs.
• Use of customized orthoses.
• Getting cortisone shots.

About 80% of people with Morton's neuroma are successful with this combined approach.

Surgery is also an effective treatment for Morton's neuroma. About 75% to 85% of people who have surgery find relief from their symptoms.

Can Morton's neuroma come back after treatment?

Morton's neuroma symptoms can come back. If you experience pain and symptoms after treatment, talk to your doctor about next steps.

living with

When should I see my doctor?

See your doctor (or a podiatrist, foot specialist) if you have:

• Severe pain that interferes with your daily activities.
• Pain that continues to get worse or returns.
• Pain that does not go away after two weeks of home treatment.
• Tingling or numbness in the foot.
• Diabetes, as people with diabetes are at greater risk of developingfoot problems.

What questions should I ask my healthcare professional?

If you have Morton's neuroma, ask your doctor:

• Can I treat this at home?
• Will I need surgery?
• Which shoes will help my foot feel better?
• Will the neuroma come back?
• What medications can help?

A note from the Cleveland Clinic

Morton's neuroma is a treatable condition of the foot. Symptoms of Morton's neuroma include pain in the toes. You may also feel like your socks are bunched up or like there's a rock under your foot. If you have pain, tingling, or other uncomfortable symptoms in your feet, talk to your doctor. Treatment for Morton's neuroma includes things you can do at home to relieve symptoms, such as rest and shoe inserts. Other treatments include medications, injections and, in severe cases, surgery. Treatment is usually successful in returning you to an active, pain-free life.