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Morton’s Neuroma

Overview

Morton’s Neuroma is a type of nerve compression syndrome which involves nerves in the lesser toes. It is characterized by fibrosis and thickening of nerve tissue between the third and fourth intermetatarsal space and is usually a result of repetitive trauma.

Symptoms
  • Pain in the ball of the foot – especially between the 3rd and 4th toes. This pain can radiate towards the toes or arch
  • Burning, tingling, and/or numbness in the toes
  • Feels like walking on a pebble
  • Pain worsens with exercise and improves with rest
  • Pain worsens with tighter footwear and high heels
Risk Factors
  • Tight fitting footwear or shoes with narrow toe box (pointed toe shoes, dress shoes)
  • Pronation, which can lower the transverse arch of the foot
  • High arches, which increases pressure on the ball of the foot.
  • Gender – Neuroma is more common in females and in active individuals, usually aged 15-50
  • Clawed toes – which can stretch the intermetatarsal structures and apply pressure to the ball of the foot.
  • Impact sport or exercise that can increase pressure on the forefoot. Examples include elliptical, cycling, dance, incline walking or running.
Treatments
  • Metatarsal pad or neuroma pad – these types of padding are placed under the ball of the foot and act to open the intermetatarsal space and reduce irritation of nerve tissue.
  • Wearing shoes with wider toe box, and lower heels to reduce pressures applied to the front of the foot and should be first line treatment of Morton’s neuroma
  • Custom foot orthotics – these custom-made devices can help further offload the forefoot and control and biomechanical abnormalities
  • Injection therapy: An alcohol solution can be injected into the nerve site at regular intervals to decrease size and subsequent pain related to the neuroma.
Prevention

Since Morton’s neuroma is caused by repetitive trauma to the nerve, either from poor biomechanics, foot type or footwear, prevention is aimed at controlling these factors. Biomechanical abnormalities are addressed with proper orthotics and exercise. Annual assessments should be scheduled to reduce risk of Morton’s neuroma. Shoes should be well fitting through the toe box. Laces or velcro enclosures can keep the foot towards the back of the shoe.

Articles about Morton’s Neuroma by Feet First Clinic

Book an appointment for morton’s neuroma

You do not need a referral to become a patient at our foot clinic. Schedule an appointment by using the Appointment Request form below or contact the clinic at 416-769-FEET(3338).