Causes and Treatment of Morton’s Neuroma

Are there treatment options for Morton’s neuroma other than surgery?

Did you ever take a step and feel like there was a rock in your shoe? Or that a tiny assailant with a cattle prod was poking you in the ball of your foot? If neither of these prove to be valid assumptions, there is a good chance that you may have developed a neuroma. 

The most common type of neuroma is Morton’s neuroma, named for Thomas George Morton, a Civil War surgeon and hospital administrator. Morton published his research on metatarsalgia, the symptoms associated with this condition, following the war. Because of this, he will forever be remembered for the pain in the bottom of the foot rather than for being the driving force behind the founding of several well-known and prominent hospitals.  

Morton’s neuroma is a swelling of the tissue that encases the digital nerve. The symptoms associated with this condition are usually felt in the ball-of-the-foot, continuing into the toes. Any kind of pressure, like standing, taking a step or simply putting on shoes can initiate some or all of the symptoms that Morton labeled metatarsalgia. These may include:

  • Thickening of the tissue that surrounds the digital nerve leading to the toes
  • Pain, often severe and/or sharp
  • Numbness
  • Tingling or a stinging sensation
  • Feeling like there is something lodged between the foot and the shoe, like a marble or a rock
  • Sudden sensation of what feels like an electrical shock, shooting from the ball of the foot into the toes
  • “Clicking”, more of a feeling than a sound, experienced while walking

Causes of Morton’s Neuroma

You may never know the exact cause of your neuroma. Researchers believe that it is likely to be the result of some sort of trauma to the nerve that was caused by it being overly stretched or compressed. What we do know is that Morton’s neuroma is found in women far more often than in men, eight to ten times more often. This leads many to assume a direct link to the type of shoes that women wear, particularly those with narrow toes and high heels. 

Other possible factors that may contribute to the development of neuromas by placing extra pressure on the ball of the foot include:

  • Fallen arches
  • Arches that are abnormally high
  • Bunions
  • Hammertoes
  • High impact sports and other activities

Treatment Options for Morton’s Neuroma

Neuromas are painful and will not go away on their own. Treatment includes a range of conservative options. These include suggestions for relieving some of the pressure on the neuroma by:

  • wearing shoes that are roomier in the toe region
  • trying inserts or custom orthotics
  • wearing pads specially designed to take the pressure off of the neuroma
  • rest and icing after periods of standing, walking or other activity
  • anti-inflammatory medications, sclerosing alcohol injections or cortisone injections 

Orthopedic surgeons will recommend surgery for a neuroma only after all other options have proven unsuccessful. The procedure is known as neuroma excision and involves the removing of the portion of the nerve that has been affected. The surgery is typically effective and the pain will be gone, but there will also be permanent numbness in the toes that were served by the nerve. 

If you have questions about a neuroma or about any other 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.