Have you started feeling pain in the ball of your foot in between your third and fourth toes? Or maybe it feels like something is inside your shoe, but when you check there's nothing there. You may have a condition called Morton's neuroma.

What Is Morton’s Neuroma?

So what is Morton's neuroma? I know it sounds like a tumor, but it's not. It's an enlarged growth of nerves that can develop between your third and fourth toes in the bottom of the foot and it's benign.

While men can get this condition, women are eight to 10 times more likely to develop it due to the types of shoes they may wear.

What Causes Morton’s Neuroma?

When the bones of your foot rub up against the nerve between your 3rd and 4th toes, they can irritate it and cause the nerve to enlarge--becoming a neuroma. Neuromas will start small. Over time, they'll progress getting larger and more painful to the point where it really makes your walking difficult.

Shoes. The most common triggers of that nerve irritation are the types of shoes you wear. If you wear pointy and or high heel shoes, you're more likely to develop the neuroma as you jam the ball of the foot into a tight space. That's because these shoes exert a lot of force on your toes. The higher the heel, the greater the force. Tighter the toe box, the squeeze gets bigger and bigger.

Abnormal Foot Structure. Having abnormal foot structure, bunions, hammertoes, flat feet, and flexible feet, all increase the risk of developing Morton's neuroma, although you can get it as well with a really high arched foot.

Trauma. Dropping a heavy object on the foot or other injuries to the area.

Sports Activities. Participation in sports activities such as running, hiking, or playing court sports.

Symptoms of Morton’s Neuroma

  • Pain
  • Tingling
  • Numbness
  • Burning
  • Feeling like you're walking on a pebble or have a sock wadded up in the ball of your foot.

Initially, these symptoms will occur occasionally, usually when wearing shoes that aggravate it or engaging in certain physical activities such as dancing in heeled shoes, hiking downhill, or cycling. The symptoms usually subside when shoes are removed or the activity stops.

Overtime the symptoms will worsen, particularly as the neuroma enlarges and the temporary changes to the nerve become more permanent. It can become difficult to walk or participate your usual activities withoujt pain.

Treatment of Morton’s Neuroma

Morton's neuroma can be treated through various methods. Some of these treatments can be done at home.

Home Treatments for Morton's Neuroma

  • Icing to relieve inflammation and swelling. You can use a bag of frozen peas or an ice pack for 20 minutes on 20 minutes off a couple times a day or after your activities.
  • Ball of foot pad or metatarsal pad can also provide the support The foot needs to prevent the metatarsals or the base of your toes from becoming cramped and pinching the nerves that cause this problem. You can either use a pad that comes separately that you can place in your shoe, or you can also find an over-the-counter insert that includes a metatarsal pad to push up just behind the ball of the foot. When you place the pad, make sure it sits just behind the area where you'll see in your shoe a little imprint of the ball of foot bones.
  • Eliminate or limit use of high heels and shoes with a narrow toe box. This can reduce rubbing on the nerve, which causes the pain. Instead, wear shoes with a wider toe box or is more open in the forefoot like a sandal.
  • Avoid wearing socks that will compress the toes too much in the front of the shoe.
  • Change how you lace shoes.
    • For example, instead of lacing your shoes starting at the bottom, move up one eyelet and that'll provide less compression in the ball of the foot and relieve the pressure on the toes and the nerves. (View Video here)
    • Also, if you have a narrow heel and your feet tend to slip forward in your shoe, you can try another lacing technique called a heel lock and help hold your foot back in the shoe. 

In Office Treatment for Morton’s Neuroma

In addition to home treatments, we'll provide several options to help you get relief from your neuroma.

Custom Orthotics for Morton's Neuroma

We recommend custom orthotics for our patients who have an abnormal foot structure such as flat feet or high arches. Wearing orthotics can realign your feet and take the pressure off the nerve.

Ultrasound Guided Injections

We provide ultrasound guided injections of alcohol in a very small amount, which will help shrink the neuroma.

MLS Laser Therapy

We use MLS laser therapy along with the injections to reduce that inflammation and pain while stimulating healing. MLS laser therapy is a cold laser that works to increase the blood supply and circulation to the area being treated, and as a result, the tissue ultimately heals itself at the cellular level.

Surgery

If the neuroma does not respond to conservative treatments, surgical removal may be necessary.

In conclusion, if you started feeling the telltale signs of Morton's neuroma, try some of these home remedies I've recommended. If these don't relieve your pain, come in so we can get you back to doing the things you love.

Dr. Rion Berg
Connect with me
A podiatrist in North Seattle treating families for over 40 years.