What is Morton’s Neuroma?

Understanding the Painful Nerve Condition

Morton’s neuroma is a painful condition that arises from the thickening of tissue surrounding the nerves that lead to the toes, typically between the third and fourth toes. This thickened nerve tissue, often the result of irritation or compression, can cause symptoms such as burning pain, tingling, numbness, or even a sensation that feels like stepping on a pebble. Although Morton’s neuroma is not life-threatening, its impact on mobility and daily activities can significantly affect quality of life if left untreated.

The condition is more prevalent in women, particularly those who frequently wear high-heeled or narrow-toed shoes, which can compress the forefoot. Athletes and individuals with certain foot shapes or structural abnormalities are also at higher risk. Early diagnosis and treatment are critical to managing symptoms and preventing the condition from worsening.

Causes of Morton’s Neuroma: Why Do My Toes Hurt?

Repetitive Irritation

Activities that place repetitive stress on the forefoot—such as running, dancing, or jumping—are common culprits behind Morton’s neuroma. The continuous strain on the metatarsal bones can irritate the surrounding nerves, leading to tissue thickening. Athletes who regularly engage in high-impact sports are especially vulnerable.

Footwear Choices

Wearing tight, narrow shoes or high heels is one of the leading contributors to Morton’s neuroma. These types of footwear compress the toes and force the metatarsal bones closer together, creating pressure on the nerves. Shoes that lack proper cushioning and arch support exacerbate the problem by failing to absorb shock adequately during movement.

Biomechanical Issues

Structural abnormalities in the foot, such as flat feet, high arches, or bunions, can cause uneven weight distribution. This misalignment increases pressure on specific areas of the forefoot, contributing to nerve irritation. People with hammertoes or other toe deformities are also at a higher risk of developing Morton’s neuroma.

Inflammatory Conditions

Inflammatory foot conditions such as bursitis or arthritis can lead to Morton’s neuroma by increasing tissue swelling and exacerbating nerve compression.

Trauma or Injury

A sudden injury to the forefoot, such as dropping a heavy object on the toes or stubbing them, can trigger the development of Morton’s neuroma. Chronic microtrauma from repetitive activities can have a similar effect over time.

Symptoms of Morton’s Neuroma: How to Recognize the Condition

Burning or Tingling Pain

The hallmark symptom of Morton’s neuroma is sharp, burning pain in the ball of the foot that may radiate into the toes. This discomfort often worsens during weight-bearing activities, such as walking or running, and may subside with rest.

Feeling of a Lump or Pebble

Many patients report the sensation of having a lump, pebble, or foreign object under the ball of their foot. This phantom sensation is caused by the swollen tissue pressing against the surrounding structures.

Numbness in the Toes

As the neuroma progresses, numbness or a tingling sensation in the affected toes may occur. This symptom is particularly noticeable after prolonged periods of standing or wearing tight shoes.

Foot Swelling and Redness

In some cases, the foot may appear swollen or red, especially if the neuroma has been left untreated and the tissue irritation has worsened over time.

Diagnosing Morton’s Neuroma

How Gotham Footcare Can Help

Comprehensive Physical Examination: At Gotham Footcare, our team of expert podiatrists begins with a thorough physical examination, assessing your foot’s structure, movement, and pain points. By gently compressing the forefoot, we can detect tenderness, swelling, or the characteristic "click" that may occur when the affected nerve is pressed.
Patient History: We carefully review your symptoms, lifestyle, and medical history to identify factors that may contribute to the condition. Details about your footwear, exercise routine, and any previous foot injuries are particularly helpful in diagnosing Morton’s neuroma.
Advanced Imaging Tests: If further evaluation is required, advanced imaging techniques such as X-rays, ultrasound, or MRI can be used. X-rays help rule out bone abnormalities like fractures or arthritis, while ultrasound and MRI provide detailed images of soft tissue changes around the nerve. These tools ensure an accurate diagnosis, paving the way for effective treatment.

Non-Invasive Treatments for Morton’s Neuroma

Shockwave Therapy

Shockwave therapy is a cutting-edge, non-invasive treatment option for Morton’s neuroma. High-energy sound waves are applied to the affected area to stimulate healing, reduce inflammation, and promote nerve recovery. Most patients report significant symptom relief after a few sessions. At Gotham Footcare, we use state-of-the-art shockwave therapy devices to ensure optimal outcomes.

Physical Therapy

Targeted exercises designed to strengthen the muscles in the foot and improve flexibility can relieve pressure on the neuroma. Physical therapy may include toe stretches, foot massages, and exercises to improve gait and balance, helping to redistribute weight across the foot.

Custom Orthotics

Custom orthotics are one of the most effective conservative treatments for Morton’s neuroma. These specialized shoe inserts provide arch support, redistribute pressure, and reduce irritation on the affected nerve. Orthotics can be tailored to fit any type of footwear, ensuring comfort and functionality.

Lifestyle Modifications

Switching to shoes with a wide toe box, low heels, and ample cushioning can significantly reduce nerve compression. Avoiding high-impact activities that stress the forefoot, such as running on hard surfaces or wearing high heels, is equally important for symptom relief.

Anti-Inflammatory Medications

Over-the-counter or prescription anti-inflammatory medications can help reduce swelling and alleviate pain. These medications should be used in conjunction with other treatments for optimal results.

Advanced Treatment Options: When Symptoms Persist

Cryoablation

Cryoablation is a minimally invasive procedure that uses extreme cold to freeze and disable the affected nerve. Performed under local anesthesia, cryoablation is a safe and effective option for patients who do not respond to conservative treatments. The procedure minimizes pain while preserving normal foot function, allowing patients to return to their daily activities quickly.

Corticosteroid Injections

Ultrasound-guided corticosteroid injections deliver targeted anti-inflammatory medication to the neuroma, providing temporary relief from pain and swelling. While not a long-term solution, these injections can be an effective bridge to other treatments.

Decompression Surgeryw

Decompression surgery is a minimally invasive option for patients with persistent symptoms. During this procedure, a skilled surgeon releases the ligament or tissue compressing the nerve, relieving pressure and reducing pain. At Gotham Footcare, we prioritize patient comfort and utilize advanced techniques to ensure a smooth recovery.

Surgical Treatments for Severe Morton’s Neuroma

Nerve Excision
In severe or recurring cases of Morton’s neuroma, surgical removal of the affected nerve may be necessary. While this procedure eliminates pain, it can result in permanent numbness in the toes. Nerve excision is typically reserved for patients who have not found relief with other treatments.

Recovery After Surgery
Recovery from surgery varies depending on the procedure performed. Decompression surgery often requires a recovery period of a few weeks, during which patients gradually resume normal activities. Physical therapy is commonly recommended to restore strength, mobility, and balance. Patients who undergo nerve excision may require a longer recovery time to adjust to the loss of sensation.

Post-Treatment Recovery

Non-Invasive Treatment Recovery
Patients undergoing treatments such as shockwave therapy, cryoablation, or corticosteroid injections typically resume normal activities within a few days. Improvement in symptoms is often noticeable within weeks, allowing patients to regain mobility and comfort.

Surgical Recovery
For patients requiring decompression surgery or nerve excision, recovery may take several weeks to months. Physical therapy plays a crucial role in ensuring optimal recovery by restoring strength and function to the foot.

Preventing Morton’s Neuroma

How to Protect Your Feet

Wear Proper Footwear

Investing in shoes with a wide toe box, low heels, and adequate arch support can prevent nerve compression. Custom orthotics offer additional support and comfort for individuals with structural foot abnormalities.

Avoid High-Impact Activities

Limiting activities that place excessive stress on the forefoot, such as running on hard surfaces or wearing high heels for extended periods, helps prevent nerve irritation.

Maintain Foot Health

Regular foot exercises, stretching, and maintaining a healthy weight are essential for preventing biomechanical issues that contribute to Morton’s neuroma. Practices such as soaking your feet and massaging them can also improve circulation and reduce stress on the nerves.

Routine Foot Checkups

Regular visits to a podiatrist can help identify early signs of foot problems, ensuring timely intervention and preventing the progression of conditions like Morton’s neuroma.

Morton’s Neuroma Frequently Asked Questions

What Is the Main Cause of Morton’s Neuroma?

The primary cause of Morton’s neuroma is repetitive irritation or compression of the nerves in the forefoot. Contributing factors include improper footwear, high-impact activities, and structural foot abnormalities.

Can Morton’s Neuroma Heal on Its Own?

While lifestyle changes and conservative treatments can alleviate symptoms, untreated Morton’s neuroma often worsens over time. Early intervention is key to preventing long-term discomfort.

How Effective Is Shockwave Therapy for Morton’s Neuroma?

Shockwave therapy is a highly effective, non-invasive treatment option for Morton’s neuroma. Many patients experience significant symptom relief after just a few sessions.

Your First Step to Getting Better

At Gotham Footcare in NYC, we strive at recognizing your individual needs and desired outcomes while formulating an effective and personalized treatment plan with the highest quality care available.

What sets Gotham Footcare apart from other podiatry offices is our dedication to providing you with the education you need to make well-informed decisions regarding your care. Regardless of what your foot and ankle trouble may be, at Gotham Footcare our team will work tirelessly to help you feel better. At Gotham Footcare, we help you put your best foot forward.

By submitting this you agree to be contacted by Gotham Footcare via text, call or email. Standard rates may apply. For more details, read our Privacy Policy.

(212) 921-7900

MORTON'S NEUROMA