Morton’s neuroma (nerve pain in foot) causes, symptoms and treatment

Medically reviewed: 1, January 2024

What is a Morton’s neuroma?

Morton’s neuroma is a condition that affects the nerves in the foot, causing pain, numbness, tingling, or burning sensations in the toes. It is also known as intermetatarsal neuroma, because it occurs between the metatarsal bones, which are the long bones in the foot that connect to the toes. Morton’s neuroma is not a true neuroma, which is a tumor of the nerve, but rather a thickening or swelling of the nerve tissue, caused by compression or irritation. Morton’s neuroma can affect anyone, but it is more common in women, especially those who wear tight or high-heeled shoes.

Key takeaways

• Morton’s neuroma is a thickening of the nerve tissue that runs between the toes, usually the third and fourth toes, that causes pain, tingling, numbness, or burning in the affected area.
• Morton’s neuroma can be caused by factors such as foot deformities, tight or high-heeled shoes, or repetitive stress or impact on the foot. It can be diagnosed by physical examination and imaging tests, such as X-rays, ultrasound, or MRI.
• Morton’s neuroma can be treated by conservative methods, such as medications, therapy, orthotics, and lifestyle changes, or by surgery, which involves removing the neuroma and part of the nerve. The treatment option depends on the severity of the symptoms, the response to conservative treatments, and the personal preferences of the patient.

Morton’s neuroma is more common in women than men, and it usually affects people between the ages of 40 and 60. It is also more likely to occur in people who have certain foot deformities, such as high arches, flat feet, bunions, or hammertoes, or who wear tight or high-heeled shoes that put pressure on the toes and the ball of the foot. Some sports or activities that involve repetitive stress or impact on the foot, such as running, jogging, dancing, or skiing, can also increase the risk of developing Morton’s neuroma.

Morton’s neuroma can interfere with daily activities, such as walking, running, or standing, and can reduce the quality of life. However, Morton’s neuroma can be diagnosed, treated, and prevented, with proper care and attention.

A Neuroma is basically a thickening of nerve fibres that can occur in any part of the body. When we talk about “Morton’s neuroma” – this refers to the most common neuroma that occurs in the metatarsal bones (the bones that link your toes to your central foot.) It was named “Morton’s” after a physician called Thomas G. Morton described the condition in 1876 (he actually got the cause wrong but the name stuck!)

It is believed that the local bones cause this Neuroma causing compression and irritation of the nerve causing it to swell and thicken. Left untreated this neuroma can lead to permanent never damage!

The classic Morton’s Nueroma location is nerve damage between the 4th and 3rd toe – 80% of sufferers are affected here and 15% have damage between the 2nd and 3rd toes.

In this article, we will discuss the following aspects of Morton’s neuroma:

• What does Morton’s neuroma look like?
• How is Morton’s neuroma diagnosed?
• How does Morton’s neuroma develop?
• Is Morton’s neuroma a tumor?
• Is Morton’s neuroma linked to ms?
• Is Morton’s neuroma dangerous?
• Is Morton neuroma surgery worth it?
• Is Morton’s neuroma curable?
• Can Morton’s neuroma go away?
• Can Morton’s neuroma be cured without surgery?
• How long does Morton’s neuroma last?
• Can Morton’s neuroma come back?
• Can Morton’s neuroma cause pain on top of foot?

What does Morton’s neuroma look like?

Morton’s neuroma is not visible from the outside, as it is located inside the foot. However, it can cause some changes in the appearance of the foot, such as:

• Swelling or inflammation of the ball of the foot, which is the area where the toes join the foot
• Redness or warmth of the skin over the affected area
• Calluses or corns on the toes, which are thickened areas of skin caused by friction or pressure
• Changes in the shape or position of the toes, such as curling, spreading, or bending
• Difficulty in wearing shoes, especially those that are tight, narrow, or high-heeled

How does it feel?

The most common signs of Morton’s neuroma is the following:

• Your foot tingles or burns and even may have numbness in areas
• The big one – Pain! Morton’s neuroma hurts real bad, this was the first sign that i noticed which eventually lead to my diagnosis.
• Sometimes people feel that there is something stuck in the ball of their foot – you might often check your shoe for an object or feel that your socks are hunched up.

The above symptoms are what early sufferers feel, however as the Nueroma progresses the following pattern is seen in sufferers.

The above symptoms start gradual at first but as it progresses they become more obvious and regular. Often in the very initial stage- you might only have problems when you wear very tight shoes or when performing feet heavy exercise.

You will find out that by massaging the foot, the main symptoms go away and by avoiding activities the symptoms are less pronounced.

However if left untreated the symptoms can become more intense and will persist for days or at worst weeks!

Can Morton’s neuroma cause pain on top of foot?

Morton’s neuroma usually causes pain in the ball of the foot and between the toes, but it can also cause pain on top of the foot in some cases. This can happen if the neuroma is located near the dorsal (top) the extensor tendons that run along the top of the foot compress surface of the foot, or.

Other symptoms, may accompany pain on top of the foot caused by Morton’s neuroma such as:

• Tingling or numbness in the toes
• Swelling or redness on the top of the foot
• Difficulty wearing shoes or walking
• Feeling of a lump or a fold in the sock

If you have pain on top of the foot that does not improve with rest, ice, or anti-inflammatory medications, you should see your doctor or a podiatrist for a proper diagnosis and treatment. Pain on top of the foot can have other causes, such as:

• Stress fracture: A small crack in the bone caused by overuse or trauma
• Tendonitis: Inflammation of the tendons that attach the muscles to the bones
• Arthritis: Inflammation of the joints that causes pain, stiffness, and swelling
• Gout: A type of arthritis that occurs when uric acid crystals build up in the joints
• Infection: A bacterial or fungal infection that affects the skin, nails, or bones of the foot
• Nerve entrapment: Compression or trapping of a nerve by a bone, ligament, or other structure

Why does Morton’s neuroma occur?

Morton’s Nueroma is commonly found among Middle aged women and there are a number of possible reasons for the condition occurring.

Here are the main causes of Morton’s neuroma:

• Wrong shoe choice

high heels are the worst culprit as they force the foot into a small toe box which puts pressure on the surrounding bones and thus inflammation of the nerve.

• Previous foot problems

Any person who has bunions, flatfeet, hammertoes or even really flexible feet is at risk for this condition. Foot problems lead to more intense pressure between the bones and over time lead to a higher risk of causing nerve damage.

• Sports damage due to repetition irritation

Any sport such as tennis or running that puts repetitive strain on the foot can lead to more risk of nerve irritation.

• Injury

Accidents that break or cause damage to the foot can also be a risk factor.

Is Morton’s neuroma dangerous?

Morton’s neuroma is not a life-threatening condition, but it can cause a lot of pain and discomfort, and affect the quality of life of the patient. If left untreated, Morton’s neuroma can worsen over time, and cause more severe symptoms, such as:

• Chronic pain in the foot, which can radiate to the leg or the back
• Feeling of numbness in the toes, which can affect the balance and coordination
• Difficulty in walking, running, or standing, which can limit the physical activity and mobility
• Infection or ulceration of the foot, which can occur due to poor circulation or trauma
• Depression or anxiety, which can occur due to the emotional impact of the condition

Therefore, it is important to seek medical attention as soon as possible, if you suspect that you have Morton’s neuroma, and follow the treatment and prevention recommendations of your doctor.

Diagnostics of Morton’s neuroma

The easiest way to get this condition diagnosed is to visit a local podiatrist/ankle surgeon. Podiatrists work only with the feet and will be able to use a variety of tests to provide an accurate diagnosis.

A doctor, who can examine the foot and ask about the symptoms, medical history, and lifestyle of the patient can diagnose Morton’s neuroma. The doctor can also perform some tests, such as:

• Physical examination: The doctor can palpate or squeeze the foot, especially the area between the toes, to feel for the presence of a neuroma. The doctor can also move or bend the toes, to check for pain or reduced mobility. The doctor can also look for signs of inflammation, calluses, or deformities in the foot.
• Imaging tests: The doctor can order some imaging tests, such as X-rays, ultrasound, or magnetic resonance imaging (MRI), to visualize the structures of the foot and rule out other conditions, such as fractures, arthritis, or tumors. However, these tests may not always show the neuroma, as it is very small and soft.

1. X-rays: These can show if there are any bone abnormalities or injuries that may be causing your pain.
2. Ultrasound: This uses sound waves to create images of the soft tissues of your foot, such as the nerves, muscles, and blood vessels. It can help detect any swelling or thickening of the nerve or other structures.
3. Magnetic resonance imaging (MRI): This uses a strong magnetic field and radio waves to produce detailed images of the tissues and organs of your body. It can show the size and location of the neuroma and any other abnormalities in the foot.

• Nerve tests: The doctor can order some nerve tests, such as electromyography (EMG) or nerve conduction studies (NCS), to measure the electrical activity and function of the nerves in the foot. These tests can help determine the location and severity of the nerve damage caused by the neuroma.

Is Morton’s neuroma a tumor?

Morton’s neuroma is not a true tumor, which is a mass of abnormal cells that grow and multiply uncontrollably. Morton’s neuroma is a thickening or swelling of the nerve tissue, caused by compression or irritation. Unlike cancer, Morton’s neuroma is benign and doesn’t metastasize or endanger the patient’s life. However, Morton’s neuroma can still cause pain and discomfort, and interfere with the normal function of the foot.

Is Morton’s neuroma linked to MS?

Morton’s neuroma is not linked to Multiple Sclerosis, which is multiple sclerosis, a chronic disease that affects the central nervous system, which consists of the brain and the spinal cord. Multiple sclerosis causes the immune system to attack the protective covering of the nerve fibers, called the myelin sheath, which causes inflammation, scarring, and damage to the nerves.

Multiple sclerosis can cause various symptoms, such as vision problems, muscle weakness, numbness, tingling, fatigue, or cognitive impairment. Multiple sclerosis can affect any part of the body, but it does not directly affect the plantar digital nerve, which is the nerve that is involved in Morton’s neuroma.

However, multiple sclerosis can affect the nerves that control the muscles and sensations in the foot, which can cause foot problems, such as spasticity, stiffness, or pain. These foot problems can increase the risk of developing Morton’s neuroma, if they cause compression or irritation of the plantar digital nerve. Therefore, Morton’s neuroma is not a symptom or a cause of multiple sclerosis, but it can be a complication or a coexisting condition.

How is Morton’s neuroma treated?

When you first visit your podiatric surgeon they will base your treatment on how far your neuroma development is. Every treatment will vary depending on how severe you particular problem is.

The treatment of Morton’s neuroma depends on the severity of your symptoms and how much they affect your quality of life. The goal of treatment is to relieve the pressure and inflammation on the nerve and to prevent further damage. There are several options for treatment, ranging from conservative to surgical. Your doctor will recommend the best option for you based on your condition and preferences. Some of the common treatment options are:

Medications

Your doctor may prescribe or recommend some medications to reduce the pain and inflammation caused by the neuroma. These may include anti-inflammatory drugs, such as ibuprofen or naproxen, or corticosteroid injections, which are injected directly into the affected area to provide temporary relief. However, these medications have some side effects and risks, such as stomach ulcers, bleeding, infection, or nerve damage, and they may not be suitable for everyone. You should always follow your doctor’s instructions and advice when taking any medications.

Therapy

Your doctor may also suggest some physical therapy or other non-invasive treatments to help you cope with your symptoms and improve your foot function. These may include:

• Padding and taping:

Your doctor or a podiatrist may apply some pads or tape to your foot to support the arch and create more space between the toes. This can help reduce the pressure and friction on the nerve and ease the pain. This involves using a variety of supports to improve the arch of the metatarsal. It’s hoped that this will take pressure away from the nerve as it reduces the compression in the foot.

• Orthotics:

These are custom-made shoe inserts that fit inside your shoes and provide cushioning and support for your foot. They can help correct any foot deformities, such as high arches or flat feet, that may contribute to the development of Morton’s neuroma. They can also help distribute your weight more evenly and reduce the stress on the ball of your foot.

• Footwear modification:

Your doctor or a podiatrist may advise you to change your footwear and avoid shoes that are too tight, narrow, or high-heeled. You should wear shoes that have a wide toe box, a low heel, and a good arch support.

• Exercises and stretches:

Your physician may teach you some exercises and stretches that can help strengthen your foot muscles, improve your flexibility, and increase your blood circulation. Some examples of exercises and stretches are:

1. Toe curls: Curl and uncurl your toes several times. You can do this with or without a towel under your toes.
2. Toe spreads: Spread your toes apart and then bring them together. Try it with a rubber band around your toes.
3. Ball roll: Roll a tennis ball or a golf ball under your foot, from your heel to your toes and back. You can do this while sitting or standing.
4. Calf stretch: Stand facing a wall and place your hands on the wall at shoulder level. Step back with one leg and keep it straight. Bend your front leg and lean forward until you feel a stretch in your calf. Hold for 15 to 30 seconds and then switch legs. Repeat two to three times on each side.
5. Plantar fascia stretch: Sit on a chair and cross one leg over the other. Hold your toes and gently pull them back until you feel a stretch in the bottom of your foot. Hold it for a while and then change. Repeat two to three times on each side.

Morton’s neuroma surgery

Surgery is seen as last resort attempt to provide relief to Morton Nueroma sufferers. Surgery usually takes the form of removing the nerve or releasing it to ease pressure.

However even after surgery – patients need to work with their Podiatrist to use long-term measures to make sure the condition does not return. These measures often include changing footwear and reducing problematic activities. If your symptoms are severe and do not improve with conservative treatments, your doctor may recommend surgery as a last resort. There are different types of surgery for Morton’s neuroma, such as:

• Decompression surgery:

This involves cutting some ligaments or tendons that surround the nerve and compress it. This can create more space for the nerve and reduce the pressure and inflammation on it.
Excision surgery.

• Endoscopic surgery:

This is a minimally invasive procedure that uses a small camera and instruments to access the nerve and the neuroma through small incisions in the foot. This can reduce the scarring and the recovery time compared to open surgery.

Surgery for Morton’s neuroma is normally done under local anesthesia, which means you will be awake but your foot will be numb. You may also receive some sedation to help you relax. The surgery usually takes about an hour and you can go home the same day. However, you will need to follow some post-operative instructions and care, such as:

• Resting your foot and keeping it elevated for the first few days after surgery
• Applying ice packs to your foot to reduce the swelling and pain
• Taking painkillers and antibiotics as prescribed by your doctor
• Wearing a special shoe or a bandage to protect your foot and prevent infection
• Avoiding putting weight on your foot for several weeks until it heals
• Doing some gentle exercises and stretches to prevent stiffness and improve your mobility
• Visiting your doctor for regular check-ups and follow-ups

The recovery time and the outcome of surgery for Morton’s neuroma vary depending on the type of surgery, the severity of your condition, and your individual factors. Some people may experience complete relief from the pain and resume their normal activities within a few weeks, while others may need several months to recover and may have some complications, such as infection, bleeding, nerve damage, or recurrence of the neuroma. Discuss the risks and benefits of surgery with your doctor before deciding to undergo it.

Is Morton neuroma surgery worth it?

Morton neuroma surgery is a surgical procedure that involves removing the affected nerve or part of it, to relieve the pressure and pain. We usually consider Morton neuroma surgery as a last resort, when other treatments, such as medication, physical therapy, orthotics, or injections, have failed to provide adequate relief. Morton neuroma surgery can be effective in reducing or eliminating the pain and other symptoms of Morton’s neuroma, but it also has some risks and drawbacks, such as:

• Recurrence of the neuroma, which can occur if the nerve regrows or forms a scar tissue
• Complications of the surgery, such as infection, bleeding, swelling, or nerve damage
• Recovery time and cost, which can vary depending on the type and extent of the surgery, and the individual condition of the patient

Therefore, Morton neuroma surgery is worth it only if the benefits outweigh the risks, and if the patient has realistic expectations and goals. Morton neuroma surgery is not a guarantee of a cure, and it may not restore the normal function or appearance of the foot. Morton’s neuroma surgery should be discussed with your doctor, who can advise you on the best option for your case.

Is Morton’s neuroma curable?

Morton’s neuroma is not curable, in the sense that there is no definitive treatment that can eliminate the cause or the source of the condition. It is because that Morton’s neuroma is a chronic condition that can recur or persist, even after treatment. However, Morton’s neuroma is manageable, in the sense that there are various treatments that can reduce or control the symptoms, and prevent or delay the progression of the condition.

Can Morton’s neuroma go away?

Morton’s neuroma can go away, or at least improve, with proper treatment and prevention. However, Morton’s neuroma can also persist or recur, if the underlying cause or the source of compression or irritation is not addressed or eliminated. Therefore, it is important to follow the treatment and prevention recommendations of your doctor, and to monitor your symptoms and foot condition regularly. Some factors that can help Morton’s neuroma go away are:

• Changing your footwear:

Wearing shoes that are comfortable, and supportive can help reduce the pressure or friction on the nerve, and allow the foot to heal and recover. You should avoid shoes that are too narrow, or high-heeled, which can squeeze or rub the toes and the ball of the foot. You should also choose shoes that have a low heel, a wide toe box, and a cushioned sole, which can provide support, cushioning, and alignment to the foot.

• Resting your foot:

Relaxing your feet helps to relieve the pain and inflammation of Morton’s neuroma, and prevent further damage or injury to the nerve. Steer clear of activities like running, jumping, or dancing that can further harm your foot and worsen your symptoms. Limit the amount of time you stand or walk, especially on hard or uneven surfaces, which can put pressure on the nerve. Elevate your foot more often and apply ice or cold packs, to reduce the swelling and pain.

• Taking medication:

It can help you relieve the pain and inflammation of Morton’s neuroma, and improve the blood flow and nerve function in the foot. Over-the-counter or prescription medication, such as anti-inflammatory drugs, analgesics, or corticosteroids, can be taken orally or injected into the foot. Do not forget to follow the dosage and instructions of your doctor, and be aware of the possible side effects or interactions of the medication.

• Wearing orthotics:

Wearing orthotics can help provide support, cushioning, or alignment to the foot, and reduce the pressure or friction on the nerve. You can wear custom-made or over-the-counter orthotics, which can include pads, arch supports, metatarsal bars, or toe spacers, depending on your needs and preferences.

• Getting injections:

By administering injections, medication can be passed directly to the affected area, offering both temporary and long-term relief from the symptoms. You can get corticosteroid injections, which can reduce the inflammation and pain of the nerve, or alcohol sclerosing injections, which can shrink or destroy the nerve tissue. You should get injections from a qualified doctor, who can determine the type, amount, and frequency of the injections, and monitor the results and side effects.

Can Morton’s neuroma be cured without surgery?

The answer to this question depends on the individual case and the severity of the symptoms. Some people may find relief from conservative treatments, such as medications, therapy, and lifestyle changes, while others may need surgery to remove the neuroma and the affected nerve.

There is no definitive cure for Morton’s neuroma, as the condition may recur or persist even after treatment. However, the goal of treatment is to reduce the pain and discomfort and to prevent further damage to the nerve. Some factors that may influence the outcome of treatment are:

• The size and location of the neuroma
• The duration and frequency of the symptoms
• The response to conservative treatments
• The risks and benefits of surgery
• The personal preferences and expectations of the patient

According to some studies, conservative treatments can be effective for up to 80% of patients with Morton’s neuroma . However, these treatments may take several weeks or months to show results, and they may not work for everyone. Some people may experience persistent or recurrent pain, or they may develop complications from the medications or injections, such as stomach ulcers, bleeding, infection, or nerve damage.

Surgery can provide permanent relief from the pain for most patients with Morton’s neuroma. However, surgery is not without risks and complications, such as infection, bleeding, nerve damage, or recurrence of the neuroma. Therefore, the decision to undergo surgery or not should be made after a thorough discussion with your doctor, who can advise you on the best option for your condition and preferences. You should also consider the potential outcomes and complications of each treatment option, and weigh them against your expectations and goals.

How long does Morton’s neuroma last?

Morton’s neuroma is a chronic condition that can last for months or years, depending on the severity of the symptoms and the response to treatment. The symptoms may vary in intensity and frequency, and certain activities or footwear may trigger or worsen them.

Some people may experience mild or occasional pain that does not interfere with their daily activities, while others may have severe or constant pain that limits their mobility and quality of life. Some people may have periods of remission, where the symptoms subside or disappear, and periods of flare-up, where the symptoms return or worsen.

The recovery time and the outcome of surgery for Morton’s neuroma vary depending on the type of surgery, the severity of your condition, and your individual factors. Some people may experience complete relief from the pain and resume their normal activities within a few weeks, while others may need several months to recover and may have some complications, such as infection, bleeding, nerve damage, or recurrence of the neuroma. You should discuss the risks and benefits of surgery with your doctor before deciding to undergo it.