What Causes Morton’s Neuroma?

Does Morton’s neuroma always cause pain?

It’s possible to have the condition known as Morton’s neuroma and never be aware of it. Morton’s neuroma is the most common form of neuroma that affects the foot. It is a mass of nerve tissue, typically benign, that is usually found surrounding the nerve that runs between the middle toes. Once it becomes large enough to display symptoms, it is often described as feeling like there is a rock in your shoe or that you are “walking on a marble”.  

No one has a definitive answer for what causes Morton’s neuroma to develop. It is believed that something happens to irritate the nerve; some form of it being stretched, squeezed, compressed or actually damaged. Women tend to develop Morton’s neuroma 8 to 10 times more often than men do, so there is a good argument to be made about high heel shoes and those with especially narrow toes being likely culprits. Research also points to the presence of other foot issues, like overly high or fallen arches, bunions and hammertoes, as well as high impact activities that place a lot of pressure on the ball of the foot. 

Who Was Morton?

Medical conditions are often named after the doctor or researcher that discovers or first describes them, although, on rare occasions, they may be named after a famous person who has been diagnosed with the condition, like Lou Gehrig’s disease (amyotrophic lateral sclerosis, or ALS). Morton’s neuroma was named for Thomas George Morton, a surgeon and hospital administrator who studied metatarsalgia, which was used to describe the symptoms that go with this neuroma. Shortly after the end of the Civil War, he published his findings, and it has been his name that is associated with this condition ever since.  

Symptoms of Morton’s Neuroma

Morton’s neuroma is rarely diagnosed visually. It is unlikely that there will be a lump or bump or anything that you can see or feel on the ball of the foot. Your doctor will ask about your symptoms, do an examination of the area and may use an ultrasound or x-ray to confirm that it is a neuroma and not an injury or some other condition, like arthritis. 

Common symptoms of Morton’s neuroma include:

  • Pain, that is often sharp or stabbing
  • General tingling in the area or a stinging sensation
  • Numbness
  • A sudden bolt, like an electric shock that starts in the ball of the foot and shoots into the toes
  • The common feeling of there being a small object inside the ball of the foot, like painfully stepping on a rock or a marble

Treatment Options for Morton’s Neuroma

Treatment options will range from conservative, non-invasive steps that include more appropriate shoes, special metatarsal pads that relieve pressure and possibly orthotics. Avoiding activities that aggravate the symptoms and using ice to reduce inflammation can also be helpful. If these are not sufficient, other types of medications, including cortisone injections may be recommended. As a last resort, surgical options are available, especially if the nerve affected by the neuroma has suffered permanent damage. 

Contact Dr. Christopher Hubbard to Schedule an Appointment

If you have questions about neuromas or about any foot or ankle concerns, Dr. Christopher Hubbard is a board-certified Orthopedic Surgeon and is the former Chief of the Foot and Ankle Service at Mount Sinai Beth Israel in NYC. To schedule an appointment, or if you just have questions, please use our convenient online contact form by clicking here.