by Rick Alan
Morton's neuroma is an inflammation of the nerves in the foot that go to the toes. Although the name includes the word “neuroma,” it is not really a tumor. It can affect any of the toes in the foot. However, it most often affects the nerves that run between the third and fourth or second and third toes.
Nerves of the Foot
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Morton's neuroma is an inflammation caused by a buildup of fibrous tissue on the outer coating of nerves. This fibrous buildup is a reaction to the irritation resulting from nearby bones and ligaments rubbing against the nerves.
Irritation can be caused by:
It is unusual for more than one Morton's neuroma to occur on one foot at the same time. It is rare for Morton's neuroma to occur on both feet at the same time.
Factors that increase your chance for Morton's neuroma include:
Symptoms of Morton's neuroma include the following sensations, usually between the third and fourth or, less often, second and third toes:
The doctor will ask about your symptoms and medical history. A physical exam will be done. Initial diagnosis of Morton's neuroma is based on your description of the type and location of pain and discomfort in the foot. The diagnosis will be confirmed by:
Images may be taken of your foot. This can be done with:
Injections of local anesthetic can also be used for diagnosis
Treatments may include:
The foot may be injected with corticosteroids mixed with a local anesthetic in order to reduce pain. Relief may be only temporary, however, if the mechanical irritation is not also corrected. Injections with other types of medications such as alcohol, phenol, or vitamin B12 are sometimes used.
Surgery to remove the neuroma may be recommended if more conservative treatment does not solve the problem. While surgery usually relieves or completely removes the symptoms, it often leaves a permanent numb feeling at the site of the neuroma.
Steps to help prevent Morton's neuroma include:
American Podiatric Medical Association
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Clinical Practice Guideline Forefoot Disorders Panel, Thomas JL, Blitch EL 4th, Chaney DM, et al. Diagnosis and treatment of forefoot disorders. Section 3. Morton's intermetatarsal neuroma. J Foot Ankle Surg . 2009;48(2):251-256.
Morton's neuroma (intermetatatarsal neuroma). American College of Foot and Ankle Surgeons' Foot Health Facts website. Available at: http://www.foothea... . Updated August 23, 2010. Accessed July 23, 2013.
Thomson CE, Gibson JN, Martin D. Interventions for the treatment of Morton's neuroma. Cochrane Database of Systematic Reviews. 2004;(3):CD003118.
Last reviewed July 2013 by Rimas Lukas, MD; Michael Woods, MD
Last Updated: 5/11/2013