What is Morton’s neuroma?

Morton’s neuroma, also called interdigital neuroma, intermetatarsal neuroma, or forefoot neuroma, is a growth caused by thickening of the nerve tissue leading to your toes. Although it’s often called a tumor, Morton’s neuroma is a benign (non-cancerous) growth that is highly treatable and generally doesn’t significantly impact your health or quality of life. It usually occurs between the third and fourth toes, but can sometimes develop between the first and second toes.  

Morton’s neuroma is fairly common, particularly among athletes whose feet experience a higher level of daily impact or those who already have podiatric (foot and ankle health) conditions. It occurs most frequently in people between 30 and 60 years old.  

Morton’s neuroma is also more common in those who wear high-heeled shoes that shift the foot bones out of their regular position. Those at higher risk of Morton’s neuroma should wear heels no higher than three inches. Wider or “chunky” heels may be a good option for those who already have the condition. Your podiatrist can help you navigate which type of shoes are best for you. 

Morton’s neuroma symptoms

Symptoms of Morton’s neuroma vary based on how much pressure has been placed on the nerves to the toes, and how long the problem has gone untreated. Some of the more common symptoms include:  

  • Burning or sharp pain in the ball of the foot 
  • Pain in the foot that radiates to the toes, particularly during walking, running, or other heightened physical activity 
  • Feeling like you’re walking on small rocks or gravel with each step 
  • Tingling or numbness in the toes  

It’s rare, but still possible, for people to experience Morton’s neuroma-related pain and discomfort from a seated or resting position. Symptoms of Morton’s neuroma are often relieved temporarily by removing your shoes or through foot massage, but they should ultimately be addressed through clinical treatment. 

What causes Morton’s neuroma?

While the exact cause of Morton’s neuroma is not known, it is linked to compression of the digital plantar nerves. This produces swelling from a nerve that goes to the toes, which creates additional pressure on the nerve from surrounding bones and ligaments. This pressure creates burning and inflammation, and may eventually cause unusual tissue to form in and around the affected nerve. 

Some of the medical and lifestyle factors that can increase the risk of Morton’s neuroma include:  

  • Co-occurring foot and ankle conditions (bunions, hammertoes, high arches, flat feet, and others) 
  • Tight or high-heeled shoes that misalign or compress the bones in the foot 
  • High-impact physical activities and athletics 
  • Weight (a higher body mass creates more strain and impact on the feet) 

Occupations that require long amounts of standing or walking can also be a factor. 

How is Morton’s neuroma diagnosed?

Once you tell your podiatrist about your symptoms, including the frequency and location of your foot pain, they will examine your feet for areas of evident tenderness, discomfort, or irritation. They may ask about your personal and family medical history to rule out any other underlying health issue.  

During the exam, your doctor will squeeze both sides of your foot and the areas between your toes to check for swelling and irritation. They may pay special attention to the third and fourth toe because that’s where Morton’s neuroma tends to develop most frequently. This physical examination should be enough to diagnose Morton’s neuroma, but your doctor may order an x-ray or MRI of the foot to be absolutely sure. 

Morton’s neuroma treatment

Morton’s neuroma can usually be treated through more mild means. These may start with basic behavioral changes, such as switching to lower-heeled shoes with better arch support and using toe crest pads or special insoles. Over-the-counter anti-inflammatory medications may also help. Additional treatments may be recommended by Penn Medicine doctors to bring you the relief you need.

Nerve Ablation
Nerve Ablation
Shock wave therapy
Shock wave therapy
Radiofrequency ablation (RFA)
Radiofrequency ablation (RFA)
Steroid Therapy
Steroid Therapy

What happens if Morton’s neuroma goes untreated?

Although Morton’s neuroma can be treated and managed fairly easily, it can also create long-term mild to moderate complications. These can include pain in the ball of the foot, numbness in the toes, and a constant feeling like there is something stuck in your shoe. As time goes on, untreated Morton’s neuroma may also lead to nerve damage. 

Preventing Morton’s neuroma

While it can be difficult to completely prevent the development of Morton’s neuroma, some behaviors may reduce risk:  

  • Wear comfortable low-heeled shoes with wide toes and adequate arch support  
  • Reduce the intensity of your exercise routine temporarily to lessen the impact on your feet 
  • Wear athletic shoes with cushion and arch support when active 
  • Get regular foot massage or reflexology treatments 

A healthy diet and taking steps to maintain a healthy weight can also help. 

Morton’s neuroma treatment at Penn Medicine

You don’t have to let Morton’s neuroma impact your health, mobility, or quality of life. Penn Medicine has experienced orthopedic specialists to help diagnose and treat your Morton’s neuroma. We use the latest imaging technology and therapies for comprehensive treatment and symptom relief. Our network of specialists is committed to helping you maintain your comfort and physical activity through effective and compassionate podiatric care.

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