What is it?
Morton’s Neuroma (MN) is a compressive neuropathy of the forefoot. This region is where the metatarsal heads “balls” meet your toes. With MN, the nerves that lie between the metatarsal bones become irritated following excessive compression or mal-loading.
- Burning, stabbing or shooting pain at the forefoot
- Tingling or numbness in between the toes
- A sensation likened to walking on a stone or marble
- Feeling as though you are walking on a folded sock
- Pain with prolonged time on the foot
What causes it?
Our current understanding of the cause of Morton’s Neuroma isn’t clear. The entrapment and compression/chronic trauma theory are the most widely accepted. Entrapment occurs between the common plantar nerve and the transverse metatarsal ligament with repeat loading during walking. Alternatively wearing, tight footwear or high heels causes neural compression and chronic irritation. With this repeated irritation, the nerve becomes thickened which creates the bulb like MN.
Morton’s Neuroma can be confirmed by history taking and clinical examination conducted by your GP, Physiotherapist or Podiatrist. Reports of pain with tight-fitting, high-heeled shoes that is relieved with removing the shoe can guide the diagnosis.
Physical examinations will look at gait, palpation of the interdigital space and the metatarsal heads and a compression test. Further investigation via X-ray may be conducted to rule out arthritis, bony masses, subluxations or dislocations. Further investigation via Ultrasound or MRI may be completed to identify the MN.
Conservative treatment options include:
- Footwear: wide, flat shoes
- Metartarsal pads
- Manual therapy
- Shockwave therapy
- Anti-Inflammatory medications
More invasive treatment options include cortisone injections or ultrasound guided injections. In some chronic cases, surgical removal of the MN is considered however there are risks of nerve traction, worsened pain and recurrence.
Working with a Physiotherapist to diagnose, educate and provide appropriate treatment options is encouraged. Call to book your appointment today!
- Munir U, Tafti D, Morgan S. Morton Neuroma. [Updated 2022 Oct 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470249/
- The centre for Mortons Neuroma. Author: Dr. Janet Pearl M.D. Available from: https://www.mortonsneuroma.com/