BALANCE Orthopaedic Foot and Ankle Center

I. Definition: Morton's neuroma is the thickening or swelling of a nerve near the toes. This condition most frequently develops between the third and fourth toes of the foot. It often feels like you're a "walking on a marble." It can cause burning or shooting pain in the ball of the foot that may radiate into the toes. The pain usually intensifies during activity or when wearing shoes. Numbness in the toes may also occur.

II. Cause: While the exact cause of Morton's neuroma is unknown, known contributing factors are tight, narrow shoes. One belief is that a nerve rubs against a ligament, causing the nerve to thicken and become inflamed. The more inflamed it becomes, the more the nerve gets irritated and pinched by the toe bones. As the process continues the nerve becomes chronically swollen, scarred, and damaged.

III. Treatment and Prevention: Patients suffering from Morton's neuroma can find pain relief in a number of ways:

Mild shoe modifications such as using shoe cushions or wearing wide, roomy shoes can take pressure off of the inflamed nerve

Orthotic devices can help in repositioning weight and pressure, thereby preventing further nerve irritation.

Cortisone injections and anti-inflammatory medications can help in relieving pain and swelling.

Your orthopaedic surgeon may recommend adhesive strapping techniques that can decrease pressure on the irritated nerve.

When conservative treatment techniques fail, surgery may be the solution. Surgical treatments for neuromas have a high success rate and a relatively short recovery period. Sometimes it can be done with a half inch incision using a small surgical telescope called an endoscope.