Like most people, you probably don’t give your feet much thought. But if you experience foot pain, you’re suddenly noticing every step you take. You’ll want to figure out what’s causing it as soon as possible, so you can walk pain free again. One possible cause of your foot pain is Morton’s neuroma.
Morton’s neuroma usually results from overly constricting footwear and affects the nerves in the ball of your foot (between your arch and your toes). It can be very painful but is also very treatable.
We’ll go over common signs and symptoms of Morton’s neuroma and how it can feel. We’ll also explain how it’s diagnosed, self-treatment options and when you should reach out to your doctor if you’re not getting the spring back in your step.
What causes Morton’s neuroma?
The human body contains trillions of nerves, and the foot contains more nerves per square inch than any other part of your body. The nerves in your feet help with toe movement, speed and other mobility functions.
But when you wear footwear that is tight or inflexible and crowds your toes, or when you consistently do activities like walking and running, the nerves between your third and fourth toes can become irritated and inflamed, resulting in Morton’s neuroma.
It’s important to note that the name Morton’s neuroma can be misleading. A neuroma is typically a benign (not harmful) tumor. Morton’s neuroma is not a tumor, and it’s not a sign or cause of cancer like an actual neuroma can be. Instead, it’s a thickening or swelling in the nerves of the foot.
Risk factors for Morton’s neuroma
This condition can be caused by a number of factors, but some things may make you more susceptible to it. Risk factors for Morton’s neuroma include:
- Genetics – While Morton’s neuroma is not an inherited condition, people with certain conditions like hammertoes, high arches, flat feet and bunions more commonly develop it.
- Footwear – Wearing shoes that place extra pressure on your toes and the balls of your feet can cause Morton’s neuroma to develop. This includes high-heeled pumps, ice skates, rollers skates, men’s dress shoes and other shoes that have a tight toe box and inflexible heels.
- Sports and activities – Frequent high-impact exercise, like running and jogging, and other activities, such as rock climbing, ice skating and skiing, can subject your feet to repeated trauma that can cause a bump.
Symptoms of Morton’s neuroma
The first indications that you may have Morton’s neuroma are persistent foot pain in the ball of your foot and the feeling that you’re “walking on a marble.” Other symptoms include:
- Pain between your toes while standing or walking
- Tingling, burning or numbness in your foot
- Swelling between your toes
Symptoms usually begin gradually, and you may not know that Morton’s neuroma is developing. They may happen only occasionally when you’re doing activities that irritate your feet, then become more consistent over time if not properly treated.
How Morton’s neuroma is diagnosed
Since Morton’s neuroma is not something that can be seen with the naked eye, a podiatrist (foot and ankle doctor) will begin by performing a physical exam of your foot, manipulating it to see if they can reproduce symptoms. They’ll also ask you about your medical history and any family history of foot problems.
Your doctor should be able to diagnose the issue after hearing about your symptoms and performing an exam, but occasionally, further testing may be needed. They may order an X-ray, which won’t show a neuroma but can help rule out other conditions, like a bone fracture, which may be causing your symptoms.
Your doctor may also order an ultrasound to take pictures of the affected nerves. If that’s inconclusive, they may then order an electromyography test to measure activity in your nerves and rule out other conditions.
Fortunately, most people don’t need surgery to help with Morton’s neuroma. They can usually alleviate their foot pain and symptoms with at-home and over-the-counter treatments.
Change your footwear to reduce symptoms
Most of the time, Morton’s neuroma is caused by footwear that irritates the nerves of the foot. You can usually easily reduce your symptoms by avoiding shoes that are too tight, have a high heel or have a thin sole.
Instead, choose shoes that have a wide, deep toe box so there isn’t pressure on the nerves. You can also buy wide shoes or use devices to stretch out shoes you already own to provide relief.
You can also try over-the-counter arch supports and foot pads. Or your doctor may prescribe custom orthotics, like shoe inserts, that are molded to fit your foot to help reduce pressure on the nerves and help with pain relief.
Try at-home remedies for Morton’s neuroma self-care
Changing your footwear is a good first step, but other self-care treatments you can try include:
- Ice massage – Icing can help with swelling and reducing pain. Try filling a paper cup with water, freezing it and rolling it over the affected area several times a day to find relief.
- Resting your feet – Try to keep your foot up and reduce or stop any activities that may be irritating your feet for a few weeks to give yourself time to heal.
- Losing weight – A little extra weight can put pressure on the feet, so losing a few pounds can help reduce pressure on the nerves.
Prescription injections and medication may provide relief
For temporary pain relief, some people find the following methods helpful:
- Foot injections – A corticosteroid can be injected into the neuroma to reduce inflammation, and alcohol sclerosing injections can help reduce the size of the neuroma.
- Over-the-counter pain relievers – Medications like ibuprofen and naproxen can help reduce pain, swelling and inflammation.
Physical therapy can decrease pain
If at-home treatments aren’t easing your pain, physical therapy is often the next step in treating Morton’s neuroma. A physical therapist can teach you stretches and other ways to relieve your symptoms so you can perform treatments at home. This can include teaching you:
- Soft-tissue massage – Regularly massaging the affected foot can help relieve tension, increase blood flow, reduce inflammation and alleviate pressure on the nerves.
- Joint mobilization – Stretching your plantar fascia and big toes, and rolling your foot over a small ball, like a golf ball, can improve symptoms and flexibility, and strengthen your foot and help with foot pain.
- Acupuncture – This is usually performed by a professional who uses needles to stimulate certain points of the body. The goal of acupuncture when treating Morton’s neuroma is to promote healing, and reduce inflammation and swelling, which in turn can help with pain.
If other methods haven’t worked, your doctor may recommend surgery
Surgery for Morton’s neuroma is usually the last option if other methods haven’t worked, because the feet take a while to heal and surgery can lead to permanent numbness in the affected toes. Surgeries your doctor may recommend include:
- Neurectomy – This surgery removes part of the affected nerve from the balls of the feet.
- Cryogenic surgery – Also known as cryogenic neuroablation, this procedure freezes the neuroma and destroys it. But because the nerve isn’t removed, there is a chance that the neuroma could come back.
- Decompression surgery – This is usually only performed when other minimally invasive surgical procedures haven’t worked. The overlying tendon that is putting pressure on the nerves is cut, which decompresses the nerve and reduces the strain on the neuroma.
Prevent Morton’s neuroma by caring for your feet
Take good care of your feet – after all, they’re the only ones you have. Wear comfortable shoes with plenty of room, avoid tight shoes with high heels, rest when you need to, stretch and exercise your feet, and follow your doctor’s orders.
Prevention is usually the best medicine when it comes to foot pain, but if you have foot pain you can’t seem to shake or are concerned you may have Morton’s neuroma or another foot condition, make an appointment with one of HealthPartners’ board-certified podiatrists. They will work with you to develop a personalized treatment plan that will get you back on your feet and doing the activities you love.