If you sometimes feel that you are "walking on a marble," and you have persistent pain in the ball of your foot, you may have a condition called Morton's neuroma. A neuroma is a benign tumor of a nerve. Morton's neuroma is not actually a tumor, but a thickening of the tissue that surrounds the digital nerve leading to the toes. Morton's neuroma occurs as the nerve passes under the ligament connecting the toe bones (metatarsals) in the forefoot. Morton's neuroma most frequently develops between the third and fourth toes, usually in response to irritation, trauma or excessive pressure. The incidence of Morton's neuroma is 8 to 10 times greater in women than in men.
Experts are not sure what exactly causes Morton's neuroma. It seems to develop as a result of irritation, pressure or injury to one of the digital nerves that lead to the toes, which triggers a body response, resulting in thickened nerve tissue (neuroma). Feet conditions/situations that can cause the bones to rub against a nerve include high-heeled shoes, especially those over 2 inches (5cm), or a pointed or tight toe box which squash the toes together. This is probably why the condition is much more common in females than in males. High-arched foot, people whose feet have high arches are much more likely to suffer from Morton's neuroma than others. Flat feet, the arch of the foot collapses. The entire sole of the foot comes into complete or near-complete contact with the ground. A bunion, a localized painful swelling at the base of the big toe, which enlarges the joint. Hammer toe, a deformity of the proximal interphalangeal joint of the second, third, or fourth toe causing it to be permanently bent. Some high-impact sporting activities including running, karate, and court sports. Any sport that places undue pressure on the feet. Injuries, an injury or other type of trauma to the foot may lead to a neuroma.
The most common symptom of Morton's neuroma is localized pain in the interspace between the third and fourth toes. It can be sharp or dull, and is worsened by wearing shoes and by walking. Pain usually is less severe when the foot is not bearing weight.
To arrive at a diagnosis, the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor attempts to reproduce your symptoms by manipulating your foot. Other tests or imaging studies may be performed. The best time to see your foot and ankle surgeon is early in the development of symptoms. Early diagnosis of a Morton?s neuroma greatly lessens the need for more invasive treatments and may avoid surgery.
Non Surgical Treatment
The best results are achieved with massage techniques that encourage spreading and mobilizing the metatarsal heads. Metatarsal spreading is one technique that can help reduce the detrimental effects of nerve compression. To perform this technique, pull the metatarsal heads (not just the toes) apart and hold them in this position to help stretch the intrinsic foot muscles and other soft-tissues. When this technique is combined with the use of toe spacers, it will be even more effective.
For those who are suffering severely with Morton?s Neuroma, surgery is a possibility. An orthopedic surgeon can remove the growth and repair your foot relatively easily. However, Morton?s Neuroma surgery is associated with a lengthy recovery time and there is a possibility that the neuroma may return.