“Doctor, the ball of my foot really hurts when I walk…it is like I am stepping on a pebble.” Does this sound like something you have experienced recently? Do you sometimes feel as if you have pain in between your toes and they go numb or tingle? If so, you could have a condition known as Morton’s Neuroma.
What is Morton’s Neuroma?
Neuromas are nerve thickenings and can develop in different parts of the body. This thickening is often painful and can potentially interrupt daily living or make simple tasks difficult. Morton’s Neuroma is a typical foot neuroma occurring between the toes, most commonly between the 3rd and 4th toes, but can also occur between other toes. With Morton’s neuroma, the thickened tissue around the nerve causes much discomfort around the ball of your foot, and may sometimes feel numb. This condition is also sometimes referred to as an “entrapment neuropathy” due to the possibility of the nerve becoming compressed with daily activities.
What Causes the Neuroma to Form? Who is at Risk?
Although the exact cause remains unclear, one of the most common causes of neuroma formation is due to continually irritation, compression, or entrapment of the nerves between your toes. Individuals who wear narrow shoes, high heels, or any shoe that causes the toes to squeeze together can lead to neuroma formation. Repeated trauma or stress from certain occupations or activities can potentially lead to neuroma formation (i.e. working with ladders, running, or standing for long periods of time).
Morton’s neuroma can occur in both genders and at nearly any age. However, women are much more at risk for developing Morton’s neuroma than men. People with certain foot types and/or deformities are also more susceptible to neuroma formation. Pre-existing conditions such as bunions, hammertoes, or flat feet tend to be more at risk for developing a neuroma; this is due mainly to the changes in stability around the toe joints.
Typical Signs and Symptoms
Symptoms vary from patient to patient and can be unpredictable. However, the most common complaint given by patients with neuromas is pain in the ball of the foot and between the toes. However, the following are additional signs to watch for if you suspect Morton’s neuroma:
- Tingling and/or numbness in the ball of your foot
- Swelling in between the toes
- Feelings of stepping on a marble or pebble when walking (may or may not be painful)
- Pain when squeezing your foot and pressing in between your toes (Known as a Mulder’s sign)
When to See Your Podiatrist
If you suspect a neuroma in your feet, then it is important you see your podiatrist to get a definitive diagnosis, and begin treatment as soon as possible. Finding the correct treatment can sometimes be difficult due to the possibility of recurrence. There are several treatment options available to you depending on the severity of your pain and overall goals. The following are recommendations to help minimize or alleviate the pain felt from the neuroma:
- Make sure to wear shoes with adequate room for your toes to move – this will help minimize compression of the space between the toes and decrease entrapment of the nerves
- Wear shoes with shock-absorbing soles to help decrease the amount of pressure applied to the ball of your foot
- Rest your foot when you can to take the pressure off your foot and ice it to help dull the pain
- Non-steroidal anti-inflammatory medications may also help provide temporary relief.
If the above treatments have not been successful, more aggressive treatment may be needed to help provide pain relief and may include: orthotics, cortisone or alcohol injection therapy or surgical excision.
If you are experiencing pain between your toes and suspect a neuroma, please do not hesitate to schedule an appointment with Dr. Gary N. Friedlander or Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale, Arizona, and have all your treatment options presented to you to ensure you continue to maintain healthy feet.