Morton's Neuroma

Walking on a ‘Marble’: Morton’s Neuroma 

Morton’s neuroma also known as the intermetatarsal neuroma is a benign, thickening of nerve tissue at the ball of the foot. It is commonly found in the area between the third and fourth toes (metatarsal bone). This condition is more prevalent in women than in men, high heels are associated with the development of Morton’s neuroma.

What Causes Morton’s Neuroma?

Morton’s neuroma occurs when the (intermetatarsal nerve) is entrapped by the deep intermetatarsal ligament. This is likely due to the repetitive compression and irritation of the nerves against the toe bones at the ball of the foot.

Another factor which is likely to develop to this condition is wearing footwear which are too tight or high heels. Such footwear gathers most of the body weight onto the forefoot, causes instability and increasing stress to that area. 

Deformed foot such as bunions, flat foot, hammer toe or high arch; or having an injury or trauma to that area also more prevalent in developing neuroma.

Signs and Symptoms of Morton’s Neuroma

It is unlikely to have any outward sign such as a lump in Morton’s neuroma. However, symptoms are usually intermittent and worsen overtime. These symptoms include:

• sensation of ‘stepping on the marble’ when waking or standing
• dull, sharp or burning pain on the ball of the foot
• pain when wearing high heels or tight and narrow shoes
• tingling or numbness sensation in the foot
• difficulty in waking

Conservative Management for Morton’s Neuroma

Depending on the severity of the condition, conservative treatments are usually recommended first. Treatment options includes:

• Icing: Ice therapy to the area helps to reduce swelling
• Shoe modifications: Changing to a footwear with a wider toe box or shoes with high heels reduces the stress on the area
• Orthotic Devices: Customized foot orthotic devices such as insoles helps to reduce pressure and compression on the nerve
• Physiotherapy: Electro modalities and targeted soft tissue massage helps to ease the pain on the ball of the foot. Exercises to stretch and strengthen the ankle and foot will also be given by the physiotherapist for better recovery