Morton's neuroma is a thickening of nerve tissue between the toes. It commonly affects the nerve that travels between the third and fourth toes. It can also affect the nerves between the second and third digits.
Morton's neuroma is more common in women than men.
The exact cause is unknown. However, some experts believe the following may play a role in the development of this condition:
- Abnormal positioning of toes
- Flat feet
- Forefoot problems, including bunions and hammer toes
- High foot arches
- Tight shoes and high heels
Symptoms of Morton's neuroma include:
- Tingling in the space between the second and third or third and fourth toes
- Toe cramping
- Sharp, shooting, or burning pains in the ball of your foot (and sometimes toes)
- Pain that increases when wearing shoes or pressing on the area
- Pain that gets worse over time
In rare cases, nerve pain occurs in the space between the second and third toes. This is not a common form of Morton's neuroma, but treatment is similar.
Exams and Tests
A foot x-ray may be done to rule out bone problems. MRI or high-resolution ultrasound can successfully diagnose Morton's neuroma. Diagnostic ultrasound is very effective in evaluating a Morton’s neuroma.
Nerve testing (electromyography) cannot definitely diagnose Morton's neuroma, but may be used to rule out conditions that cause similar symptoms.
Nonsurgical treatment is tried first. Your doctor may recommend any of the following:
- Padding and taping the toe area
- Shoe inserts
- Changes to footwear (for example, shoes with wider toe boxes)
- Anti-inflammatory medicines taken by mouth or injected into the toe area
- Nerve blocking medicines injected into the toe area
- Other painkillers
- Physical therapy
Anti-inflammatories and painkillers are not recommended for long-term treatment.
In some cases, surgery may be needed to remove the thickened tissue. This can help relieve pain and improve foot function. Numbness after surgery is permanent, but should not be painful.
Nonsurgical treatment does not always improve symptoms. Surgery to remove the thickened tissue is successful in about 85% of cases.
Avoid ill-fitting shoes. Wear shoes with a wide toe box.