Morton's neuroma is a painful condition that affects the ball of the foot, specifically the area between the third and fourth toes. It is caused by the thickening of the tissue that surrounds one of the nerves leading to the toes, which can result in numbness, tingling, and burning. If left untreated can result in nerve damage and chronic pain. This condition affects women more often than men and is more common in middle-aged people.
Symptoms of Morton's neuroma typically include and are found in the ball of the foot.:
burning
tingling
numbness sensation
Folks describe feeling like they have a bunched-up sock or a pebble in their shoe. The pain can become more severe when walking or standing, and some people may experience shooting pain in their toes.
The exact cause of Morton's neuroma is not known. People who experience Morton’s neuroma may also have a history of carpal tunnel. There are several factors that can increase the risk of developing this condition. These include wearing high heels or tight narrow shoes that compress the toes. Participating in high-impact activities that involve running or jumping puts increased stress on the ball of the foot causing irritation to the nerve. Certain foot deformities, such as flat feet, hammer toes, or bunions also play a part in the condition by putting more stress on the central part of the ball of the foot.
Diagnosis of Morton's neuroma typically involves a physical exam and a review of the patient's medical history and symptoms. During the exam, the doctor will check for tenderness in the affected area and may apply pressure to the foot to reproduce the patient's discomfort. We may be able to elicit an audible click, the nerve rolling over the metatarsal heads. At our office, we use ultrasound to visualize the neuroma in between the toes. In some cases, imaging tests such as an MRI or an X-ray may be used to rule out other possible causes of foot pain like a stress fracture or inflammation in the joints.
At Lighthouse Foot and Ankle, our ultimate goal is to provide relief and address the root cause of the condition Treatment for Morton's neuroma typically involves conservative measures. We start by looking at the patient’s shoes. We recommend purchasing shoes with a wide toe box and adjusting the shoe laces to take pressure off the ball of the foot. This is especially helpful if the patient has a hammer toe or bunion. Orthotic inserts with a metatarsal pad reduce pressure on the ball of the foot. We can add a metatarsal pad to the shoe sock liner or cast the patient for custom molded orthotics to decrease pressure on the ball of the foot. We recommend taking anti-inflammatories only in the initial stages of neuroma pain. Toe spacers such as Correct Toes separate the metatarsal taking pressure off the nerve. We think of this as resetting the foot after being crammed into shoes all day. This also helps with hammer toes and bunion deformities.
Our treatment of choice for neuromas is low-level light laser therapy, also known as cold laser. We use a class 3 cold laser directly on the foot to decrease pain and inflammation in the area. We have used the laser successfully in treating acute and chronic neuroma pain. The painless treatment takes about 10 minutes and there is no downtime. The laser does not eliminate the neuroma but does decrease the inflammation around the nerve so you no longer feel the pain, burning, or tingling pain. Our goal is to reduce and eliminate the need for surgical intervention. In rare instances, laser therapy did not eliminate the discomfort we have not burned any bridges. Patients can be referred for cryoablation or excision.
In conclusion, Morton's neuroma is a painful condition that affects the ball of the foot, and it can have a significant impact on a person's quality of life. While there is no cure for this condition, there are several treatment options available that can help to manage symptoms and provide relief. If you are experiencing foot pain reach out to us and we can help you find the underlying cause and to develop an appropriate treatment plan. By taking steps to prevent Morton's neuroma, you can reduce your risk of developing this condition and maintain healthy, pain-free feet.
