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Common Conditions

Morton’s Neuroma

25/09/2020

A Morton’s Neuroma is a benign (noncancerous) swelling along a nerve in the foot that carries sensations from the toes. This neuroma usually occurs in the foot between the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma. Intermetatarsal describes its location in the ball of the foot between the metatarsal bones. The thickening of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates enlargement of the nerve. Once the swelling begins, the nearby bones and ligaments put pressure on the nerve causing more irritation and inflammation, eventually leading to permanent nerve damage.

Anything that causes compression or irritation of the nerve can lead to the development of a neuroma. One of the most common offenders is wearing shoes that have a tapered toe box or high-heeled shoes that cause the toes to be forced into the toe box. People with certain foot deformities such as bunions, hammertoes, flatfeet or more flexible feet are at higher risk for developing a neuroma. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running or court sports. An injury or other type of trauma to the area may also lead to a neuroma.

With Morton’s neuroma, there is no outward sign of this condition such as a lump. Instead, symptoms such as a feeling as if standing on a pebble in a shoe, burning pain in the ball of the foot that may radiate into the toes and tingling or numbness in the toes may be experienced. The progression pattern of a Morton’s neuroma typically starts with the symptoms beginning gradually. At first, they occur only occasionally when wearing narrow-toed shoes or performing certain aggravating activities. The symptoms may go away temporarily by removing the shoe, massaging the foot or avoiding aggravating shoes or activities. Over time, the symptoms progressively worsen and may persist for several days or weeks. The symptoms then become more intense as the neuroma enlarges and the temporary changes in the nerve become permanent.

Physical therapy plays an important part in the treatment of Morton’s neuroma. Conservative and non-surgical interventions including physical therapy are the often first line of therapy in the management of Morton’s neuroma. Treatment will be focused on redefining and improving the foot mechanics to alleviate the symptoms of Morton’s Neuroma. Muscle stretching and muscle strengthening exercises will also be prescribed to manage the pain. As the treatment progresses, gait modifications and lifestyle recommendations will be incorporated to help restore optimal body mechanics and balance to improve healing and rejuvenation. If in doubt, seek professional advice.