Morton's neuroma, also called Morton's metatarsalgia, Morton's disease, Morton's neuralgia, Morton metatarsalgia, Morton nerve entrapment, plantar neuroma, or intermetatarsal neuroma is a benign (non-cancerous) growth of nerve tissue (neuroma) that develops in the foot, usually between the third and fourth toes (an intermetatarsal plantar nerve, most commonly of the third and fourth intermetatarsal spaces). It is a common, painful condition.
Morton's neuroma seems to occur in response to irritation, pressure or injury to one of the nerves that lead to your toes. Factors that appear to contribute to Morton's neuroma include. High heels. Wearing high-heeled shoes or shoes that are tight or ill fitting can place extra pressure on your toes and the ball of your foot. Certain sports. Participating in high-impact athletic activities such as jogging or running may subject your feet to repetitive trauma. Sports that feature tight shoes, such as snow skiing or rock climbing, can put pressure on your toes. Foot deformities. People who have bunions, hammertoes, high arches or flatfeet are at higher risk of developing Morton's neuroma.
Patients will often experience a clicking feeling in the forefoot followed by a sharp shooting pain or a sensation of numbness or pins and needles extending into ends of their toes. Tight narrow fitting shoes may often exacerbate these feelings which become worse after long periods of standing or walking. Once the Mortons nueroma progresses symptoms will become more frequent and often more intense.
Plain x-rays of the foot may demonstrate that one or more of the metatarsals are long (Figure #5). Not uncommonly, the second and/or third metatarsal may be long relative to the third or fourth. This can create a situation where excessive load is occurring in and around the vicinity of the interdigital nerve.
Non Surgical Treatment
Rest. Continuing with normal training will increase pain and inflammation and prevent the injury from healing. Wear a metatarsal pad under the forefoot which will raise and spread the bones of the forefoot taking the pressure off the nerve. Wearing metatarsal pads in the shoes under the forefoot spreads the metatarsals creating more space for the nerve. See a sports injury professional who can advise on treatment and rehabilitation. Orthotic inserts may be required to correct any biomechanical dysfunction of the foot.
Recently, an increasing number of procedures are being performed at specialist centers under radiological or ultrasound guidance. Recent studies have shown excellent results for the treatment of Morton's neuroma with ultrasound guided steroid injections, ultrasound guided sclerosing alcohol injections, ultrasound guided radiofrequency ablation and ultrasound guided cryo-ablation.