Introduction

Morton’s Neuroma is a painful condition that causes burning, neuropathic pain, tingling, plantar forefoot pain, or numb sensation in the ball of the foot, and can be caused by several factors. It is also called intermetatarsal bone; thickening of tissue in the toe. With Morton’s Neuroma, you feel like you have pebbles inside your shoe

A person with Morton’s Neuroma might feel neuropathic pain near the ball of their foot when walking, running, or jumping because the activity subjected their feet to repetitive trauma. Here are some things you should know about Morton’s neuroma:

Risk Factors of Morton’s Neuroma

Your risk for getting Morton’s Neuroma may be higher if you are having;

Certain Medical Conditions

 Morton’s Neuroma can be developed over time if you have some medical conditions. These conditions include hammertoes and bunions.

Certain Foot Shape

 People born with high arches, flexible foot, hammertoes, or toes in an abnormal position or people born with flat feet have a higher risk of instability around the toe joints. This instability might lead to Morton’s neuroma.

Shoe Choice

 Pointed-toe shoes and tight-fitting shoes can cause problems, so also high heel shoes (heels above 2 inches high). These shoes exert more pressure on the balls of the feet and restrict the free movement of the toe.

Sports

 Sports like football, basketball, tennis, and running put a lot of pressure on the balls of the feet of sportsmen as they run. This pressure can lead to Morton’s neuroma.

Morton’s Neuroma Symptoms

You may not see a noticeable sign on your foot; since it is not a tumour or lump. At first, you may feel the neuropathic pain slowly; and if it is not improved, the pain increases. The first sign is that you will have a tingling feeling between your toes. Subsequently, the following symptoms show;

• The tingling feeling increases as time goes by.
• Around the base of your toes or the ball of your foot, you may feel pinching and shooting pains
• Your toes may burn or feel numb
• There is a sensation that something is inside the ball of your toes
• Your foot might feel like there is a pebble or rock in your shoe or your sock is bunched up.
• There is a swelling between the toes
• Pain gets worse when you stand on the ball of your foot or wear high-heeled shoes narrow shoes, narrow-toed shoes
• The neuropathic pain increases when you walk
• The discomfort gets worse when you wear shoes that squeeze your feet
• The pain ease at night

Causes of Morton’s Neuroma

Morton’s neuroma is caused by a damaged or irritated nerve between the toe bones. You may feel this pain on the ball of your foot. Common causes of damage to nerve include;

• Wearing shoes that are not supportive or shoes that put the foot bones in a bad position. Supports include arch support, toe support, and heel support.
• Being born with a certain congenital foot problem. Foot problems include flat foot, high arch, and high toe.
• Wearing shoes that do not have good shoe pads
• Morton’s neuroma can also happen as a result of a combination of shoe changes
• Pressuring the ball of the foot during high-density sports. Sports include jumping, running, basketball, and football

Prevention of Morton’s Neuroma

• Avoid tight shoes or high heel shoes for long
• To avoid your toe be cramped, wear supportive shoes with a wider toe box
• If you would be doing an activity that involves high-density landing, wear athletics shoes with good arch support and plenty pad to cushion the balls of your feet
• Since extra weight put more pressure on your foot, maintain a healthy weight
• If you notice your activity involves high-density landing, tweak your activity to reduce pressure on your foot.

When Should I visit my doctor?

• When pain continues to get worse
• Pain that doesn’t stop after a week or two
• When you feel numb or tingling in your foot
• Pain goes away in the night and comes back during the day

Diagnosis of Morton’s Neuroma

To tell if you have Morton’s Neuroma, you need to visit a doctor. Your doctor will examine you and confirm if it is Morton’s Neuroma and not some leg tumour or other injuries. To diagnose you, your doctor will do any of the following:

Find out about symptom history

Your doctor will ask you about the experiences of pain, when it started, your activities, your work, type of shoe you wear

Do a physical examination

 Your doctor will likely conduct a physical exam by pressing your foot to check for soft spots. If there are any clicks between the toes, that shows the presence of Morton’s neuroma

Perform a Motion Test

Your doctor will move your toe and feet to check the cause of the pain. Some pain shares similar symptoms with Morton’s neuroma; these pains include joint inflammation and arthritis. 

X-ray

An X-ray test will show the doctor the exact problem, and rule out other problems like fracture if he/she suspects other nerve conditions

Ultrasound

A good way to spot Morton’s neuroma is through the use of imaging studies like ultrasound test. An ultrasound test uses sound waves to create an image of the inner section of the body, showing the exact tissue that is faulty in the body.

Magnetic Resonance Imaging Test

Like Ultrasound, Magnetic Resonance Imaging (MRI) uses a magnetic field and radio waves to look for soft tissues in the body. Although it is the best test for diagnosis, it is hardly used because it is expensive.

Use of Electromyography Procedure

 This procedure checks the electrical activity of the muscles and nerves. It rules out nerve features that can lead to symptoms of Morton’s neuroma.

Morton’s Neuroma Treatments

Treating Morton’s neuroma can vary in people, as prescription depends on the doctor’s diagnosis and analysis after checking your medical reports. Also, treatment depends largely on the severity of the symptoms. Here are treatment options for Morton’s Neuroma.

Physical Therapy

One of the initial treatments your doctor will prescribe to you is physical therapy or a pain management doctor that demands you should change your shoe for a better one that will give enough room to the ball of your feet and your toe. You will also be advised to use a shoe with better footpads and arch support such as a metatarsal insole inside your shoe. This can be gotten over online or through special orders.

Home Treatment

• Take a break off your daily high-impact activities like running, jogging, dancing, or any exercise that subject your feet to high-impact landing. This process requires less recovery time where you will stay off standing.
• Wear a shoe with a good shoe pad
• Change your footwear and avoid tight shoes or heel shoes. Wear shoes with plenty of big toe boxes and extra cushion or arch support instead.
• If your feet still hurt after getting a new shoe, get a custom shoe insert an orthotic insert to prompt pain relief
• Massage with ice regularly to reduce pain. Use ice in a bottle and roll it over the painful site frequently every day.
• Because your weight exerts pressure on your feet, ensure to shed extra pounds
• Take anti-inflammatory drugs and nonsteroidal anti-inflammatory drugs recommended by your doctor. Drugs to use include naproxen sodium (Aleve) or ibuprofen (Advil, Motrin IB, others).

Surgical Procedures

If the above methods could not help you even after conservative treatment, your physical therapist may suggest an aggressive treatment to ensure effective treatments

• Getting injected. Steroids, Cryogenic neuroablation, alcohol injections will be injected into the painful site; although alcohol injections may only be effective for five years, it minimizes the pain at that moment. Alcohol sclerosing injections, Anesthetic Injection, corticosteroid injection, and cortisone injections can also ensure proper injection therapy.
• Removal of the damaged nerve. If the pain still insists, the damaged nerve causing that pain will be removed. After removal, there would be permanent numbness in the once painful area after some myelin sheath has been destroyed.

Conclusion

Morton’s neuroma is not a terminal disease that kills; it is a treatable foot pain instead. It includes pain on your toes, ball of your foot, pin-like pain under the feet, and numbness of the feet. If you will notice these symptoms, visit your doctor to do a proper diagnosis. Your doctor would prescribe treatment based on the severity of your pain. 

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