… also known as intermetatarsal neuroma, is a condition where there is a neuroma between the metatarsals of your foot, near the balls of your feet or your “fore foot”. A neuroma is a benign growth of nerve tissues that can cause burning pain, numbness, and tingling. The cause of Morton’s neuroma is often tight shoes and hypertonic muscles in the foot overtime. Hypertonic muscles describe muscles that do not know how to relax – they are in a constant state of “high tone”. As a result, the muscles pinch nerves and blood vessels in the area. Nerves will start to thicken its surrounding sheath (akin to a coffee cozy for a cup of coffee) to protect itself. Overtime, the tissue hardens and a neuroma is formed. Muscles that affect Morton’s neuroma most commonly are lumbricals or interossei muscles that are located in between the metatarsals.
People with Morton’s neuroma would feel discomfort in their forefoot between the foot arch and the toes. Most common area is between the third and fourth toes. Early signs include discomfort or pain when wearing narrow footwear, but better when barefooted or after massaging your foot. Burning sensations and pain when you squeeze your feet are also signs of this condition. You may also feel like something is in your shoe or your sock bunching up in the ball of your foot when you walk. Overtime, the condition progresses to the point where pain is present constantly, even when you’re barefooted. Diagnosis is as simple as getting a diagnostic ultrasound done for your affected foot.
As for treatment, the key is early diagnosis and treatment prior to the neuroma solidifying into somewhat of a “callus”. Myofascial release and soft tissue therapy to the involved muscles as well as acupuncture to the neuroma has been shown to reduce symptoms. Strong intrinsic foot muscles will aid in the release of hypertonic muscles. Avoiding narrow footwear such as high heels and aggravating activities are important to reduce further irritation to the nerves in the foot. Orthotics with padding can be used to further minimize repetitive pressure on the neuroma when you’re on your feet all day.
If conservative treatment does not improve your symptoms, your doctor may suggest a cortisone injection into the neuroma. If no relief is found with cortisone, your doctor may refer you to a foot specialist for a consultation on possible surgery to resect a section of your nerve or to release the surrounding soft tissue to make more room for the neuroma. Most of the time, a change to proper footwear and conservative treatments are enough to minimize discomfort and pain caused by Morton’s neuroma.
If you have any questions or think you may have the inklings of a Morton’s neuroma, feel free to contact one of our practitioners for a free 15-minute consultation.
Written By: Danette Lam, MScPT
