What is a Mortons Neuroma?
A Morton's Neuroma is a painful condition involving the nerve supply in the ball of the foot. Patients with a mortons neuroma usually experience discomfort in between the third and fourth metatarsal heads which can radiate into the third and fourth toes. The condition is usually caused by excessive pressure, irritation or injury to the nerve.
The natural history of a neuroma may vary from person to person but if left untreated it may lead to permanent nerve damage.
- Burning, tingling, aching or cramping sensation in the area between the third and fourth metatarsal heads which can radiate into the third and fourth toes
- Pain may become worse when wearing tight shoes or walking for long distances
- Numbness in the ball of the foot or toes
Initial treatment may involve wider fitting shoes with more cushioning. Tight shoes and shoes that lack cushioning will likely compress and irritate the nerve.
When it comes to selecting appropriate athletic or running shoes, consider the following shoe width guides:
- For Men – 2E (wide) or 4E (extra wide)
- For Women – D width (wide) or 2E (extra wide)
From our experience we have found this type of shoe (or something similar) to be very useful for patients who have symptomatic mortons neuroma:
For more information on these shoes, you can visit the company's website.
To find out if the shoe fits properly remove the innersole from shoe, place it on the ground and then stand on it. If the front of the foot is overhanging the edges of the innersole then the shoe is too small.
In addition, patients may also benefit from icing the ball of the foot once – twice daily, anti-inflammatory medication, in-shoe padding and cortisone injections.
In most instances, the above advice will help most people. Sometimes people may require foot orthotic therapy. In the right situations, foot orthotic therapy may be helpful in reducing the compression forces on the nerve. Foot orthoses are designed to improve foot function and will help splay the metatarsal bones to take the pressure of the nerve.
Foot orthoses will have a tendency to take up more room in the shoe thus making the shoe tighter. As a result, unless wider fitting shoes are able to be worn foot orthoses are unlikely to work.
Lastly, if conservative management is unsuccessful surgical treatment may be an option. Surgery involves resecting a small portion of the nerve and releasing the tissue around the nerve.