Updated: Aug 9, 2019
By Rachel Munnink, Podiatrist
Pinching, burning, shooting or sharp pain in the forefoot? You could be suffering from a Morton’s Neuroma
Morton's neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes.
Morton’s Neuroma is a compression injury to the nerve between the toes, which causes enlargement and thickening of the nerve. This enlargement and thickening of the nerve then takes up more space in-between the bones (the metatarsals) of the toes, leading to increased compression and more frequent pinching of the nerve with a sharp shooting pain, burning or numbness that can be felt on the ball of the foot.
It commonly affects the nerve that travels between the bones of the third and fourth toes. This area is prone to compression due to the anatomy of the nerve, as it splits at this region to form the plantar digital nerves.
Causes of Morton’s Neuroma:
Compression from anatomical foot deformities such as bunions, hammertoes, high arches or flat feet
Excessive rolling in of the feet (causes the foot to be a loose bag of bones and more likely to trap the nerves running between the toe bones).
Trauma – in particular high-impact sports such as running may subject your feet to repetitive trauma or sports that involve tight shoes such as snow-skiing or soccer boots
High heels (more weight placed on the balls of the feet).
Narrow or pointed toe box of shoes causes the bones to “squash” and compress the nerves in the forefoot.
Symptoms of Morton’s Neuroma:
Neurological symptoms such as numbness, burning or tingling
Sharp, stabbing pain
Aggravating factors include: weight bearing, pointed shoes, high heels, thin-soled shoes and tight socks.
Alleviating factors include: rest, removal of shoes and socks and massaging the affected area.
Positive Mulder’s sign – a diagnostic examination performed by the podiatrist
Treatment for Morton’s Neuroma
Suitable footwear with a wide and deep toe box – avoid high heels which have been linked to the development of Morton’s Neuroma and put more pressure on the ball of the feet
Foot paddings or metatarsals domes which aim to separate the metatarsal bones and alleviate pressure
Strapping, taping or orthotics to improve biomechanical abnormalities which may be contributing to the compression
Foot Mobilisation Therapy to reduce stiffness of the joints and improve alignment of anatomical structures thereby reducing pressure on the nerve
Surgical intervention if conservative treatment is not successful – this may involve a corticosteroid injection, decompression surgery or removal of the nerve