If you constantly feel like there’s a pebble in your shoe when you walk, or if you feel pain between your toes, you may have a condition called Morton’s neuroma.
At Monroe Foot & Ankle Care, board-certified podiatrist Dr. Elliott Perel and his staff treat all manner of podiatric conditions, including Morton’s neuroma. If you’re experiencing pain between your toes or the constant feeling that there’s something in your shoe, you need to come in and see the doctor. Left untreated, Morton’s neuroma can lead to permanent nerve damage.
What is Morton’s neuroma?
Morton’s neuroma affects the ball of your foot between the metatarsal bones and the phalanges (toe bones). If the nerve between the bones becomes swollen and inflamed, you feel it on the bottom of your foot, between your toes. The neuroma can cause pain and make it difficult to walk.
The problem starts when the nerve suffers excessive pressure or your toes become compressed, such as when you wear high-heeled shoes. The compression (squeezing) leads to inflammation and irritation.
The “neuroma” in Morton’s neuroma is somewhat misleading, in that neuromas are noncancerous tumors that develop on nerves throughout the body. The tumors derive from a growth of extra nerve tissue.
However, with Morton’s neuroma, there’s no extra tissue growth and no tumor. Instead, the tissue that surrounds the nerve becomes inflamed and gets bigger.
Usually, Morton’s neuroma develops between the bones of your third and fourth toes, though it sometimes occurs between the second and third toes.
Morton’s neuroma is common, with about 1 in 3 people affected. Women are about 8-10 times more likely to develop it than men, largely because of shoe choice.
Morton’s neuroma symptoms
You probably won’t see any signs of the neuroma on your foot; since it’s not a tumor, there won’t be a lump. However, you may see some swelling between the toes. You may also feel some pain, though it starts slowly. If the condition isn’t too advanced, you can often relieve the discomfort by massaging your foot.
Symptoms include:
- Sharp, stinging, or burning pain between the affected toes when standing or walking
- Swelling
- Tingling and numbness
- Feeling there’s a bunched-up sock or pebble under the ball of your foot
- Pain that’s worse when you wear high-heeled shoes or stand on the balls of your feet
Symptoms generally get worse over time.
Diagnosing and treating Morton’s neuroma
Dr. Perel can generally diagnose Morton’s neuroma based on your symptoms and a physical exam. X-rays don’t show the presence of a neuroma, but they can help rule out other potential causes, such as a stress fracture or arthritis. An ultrasound or MRI can confirm the diagnosis. The doctor may also perform an electromyography, which measures the electrical activity of your nerves and muscles. It rules out nerve conditions that can cause symptoms similar to those of Morton’s neuroma.
You may need a combination of treatments to get the most relief.
At-home steps you can take to relieve symptoms include:
- Wear supportive shoes with a wide toe box, shock-absorbent soles, and proper insoles
- Use an ice pack to reduce pain and swelling
- Rest and massage your feet; avoid activities like high-impact sports that put added pressure on your feet
Dr. Perel may also use medications, including:
- Steroid injections
- Alcohol sclerosing injections: alcohol solution reduces nerve pain
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Anti-inflammatory drugs injected into the skin
- Local anesthetic injection that numbs nerve and relieves pain
Orthotics are a great noninvasive option to help relieve your symptoms. These custom-made shoe inserts take the pressure off the painful nerve. In addition, metatarsal pads can offload the stress on the ball of your foot where you’re having pain.
If medications and other conservative treatments haven’t worked, Dr. Perel may recommend foot surgery, most commonly a neurectomy, where he removes part of the nerve tissue, or radiofrequency ablation, where he uses an electric current to heat and deactivate the nerve, alleviating the pain. While surgery can be a successful option, some people develop permanent numbness in the affected toe.
If you’re bothered by the feeling there’s something stuck under your toes when you walk, it’s time to schedule a consultation with Dr. Perel at Monroe Foot & Ankle Care to determine if it’s Morton’s neuroma.
To get started, give our office in Jamesburg, New Jersey a call at 732-521-6166, or book online with us today.