Ever wonder why your feet hurt every time you put on your shoes or exercise? It may be a Morton’s neuroma.
What is a neuroma?
A neuroma is a thickening of nerve tissue due to compression and irritation of the nerve, which can occur anywhere in the body. The most common neuroma in the foot is a Morton’s neuroma, which occurs between the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma, referring to its location in the ball of the foot between the metatarsal bones.
The incidence of Morton's neuroma is 8 to 10 times greater in women than in men.
Causes
One of the most common causes of a neuroma is improper shoes. Tight, narrow shoes cause the toes to be forced into the toe box (the section of footwear that surrounds the toes on closed-toe shoes), which can lead to compression of the bones and pinching on the nerve. In addition, high-heeled shoes put a lot of pressure on the ball of the foot, which also can irritate the nerve.
Certain foot deformities such as bunions, hammertoes or flat feet also put you at higher risk for developing a neuroma, as can activities that involve repetitive irritation to the ball of the foot, such as running or tennis.
In addition, an injury to the foot may lead to a neuroma.
Symptoms
A Morton’s neuroma may cause one or more of these symptoms:
- Tingling, burning, numbness to, or pain in, the toes or the ball of the foot.
- A feeling that something is inside the ball of the foot, or the ball of the foot is swollen.
- A feeling that there is something in the shoe like a pebble, or that your sock is bunched up.
Symptoms begin gradually, initially only occurring when you wear narrow-toed shoes or perform certain aggravating activities. They symptoms may go away temporarily by removing the shoe, massaging the foot or avoiding aggravating activities. However, in some cases the symptoms progressively worsen and may persist for days or weeks.
Treatment
Initial treatment is nonsurgical:
- Proper footwear: Avoid high heels or tight shoes. Wear wider shoes with lower heels and a soft sole. This enables the bones to spread out and may reduce pressure on the nerve, giving it time to heal.
- Orthotics: Custom shoe inserts and pads help relieve irritation by lifting and separating the bones, reducing the pressure on the nerve.
- Cortisone injection: One or more injections can reduce the swelling and inflammation of the nerve.
- Nonsteroidal anti-inflammatory medication: Products like ibuprofen can also decrease the swelling of the nerve.
Studies have shown that a combination of wider, more comfortable shoes, nonsteroidal anti-inflammatory medication, custom foot orthoses and cortisone injections provide relief in over 80% of people with Morton's neuroma.
If conservative treatment does not relieve your symptoms, you may discuss surgical treatment options with your podiatrist.
Remember, foot pain is not normal and you should never ignore it. If you are experiencing foot pain, visit your podiatrist.
Dr. Michelle Castiello is a podiatrist at Scarsdale Medical Group, seeing patients at 600 Mamaroneck Avenue, Suite 102 in Harrison. To make an appointment, call 914-723-8100.