Morton neuroma is painful thickening of the tissue around one of the nerves in the foot. 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 between the second and third toes.
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The thickening of the nerve caused by inflammation and the build-up of fibrous tissue on the nerve's outer coating. This fibrous build-up 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 neuroma to occur on one foot at the same time. It is rare for Morton neuroma to occur on both feet at the same time.
Morton neuroma is more common in women. Other factors that may increase your chance of Morton neuroma include:
Morton neuroma may cause:
The doctor will ask about your symptoms and medical history. A physical exam will be done. Initial diagnosis of Morton neuroma is based on your description of the type and location of pain and discomfort in the foot. The diagnosis will be confirmed by:
Imaging tests evaluate the foot and surrounding structures. This may 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 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.
To help reduce your chance of Morton neuroma:
American Podiatric Medical Association
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Canadian Orthopaedic Association
When it Hurts to Move—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 neuroma. EBSCO DynaMed website. Available at:http://www.dynamed.com/topics/dmp~AN~T114041/Morton-neuroma. Updated June 8, 2016. Accessed September 5, 2019.
Morton's neuroma (intermetatarsal neuroma). Foot Health Facts—American College of Foot and Ankle Surgeons website. Available at: http://www.foothealthfacts.org/footankleinfo/mortons-neuroma.htm?terms=morton%27s%20neuroma. Accessed September 5, 2019.
Thomson CE, Gibson JN, Martin D. Interventions for the treatment of Morton's neuroma. Cochrane Database of Sys Rev. 2004;(3):CD003118.
Last reviewed September 2019 by EBSCO Medical Review Board Donald W. Buck II, MD Last Updated: 9/4/2020