Morton’s neuroma is caused by a growth in the nerve between the third and fourth toes where they attach to the foot. This is not a cancer, but better imagined as a small ball of nerve tissue.
The cause is not known, but it is more common in women and tight fitting shoes or abnormal bony development may contribute to Morton’s neuromas. Athletes who wear tight footwear (skaters, dancers, rock climbers, skiers and runners) seem to develop Morton’s neuromas more frequently.
Morton’s neuroma pain is felt most often between the third and fourth toes where they attach to the foot. It may feel as though there is a pebble or marble under the foot with walking. A burning pain may be felt in the sole of the foot or into the toes, occasionally with numbness. It is worse with running, standing, and pressure from tight shoes or high heels. Pain at night is unusual, which makes this different from other painful nerve conditions (such as carpal tunnel syndrome) which is usually worse at night.
Examining the area by pressing on the space between the base of the toes may be painful, and a click may be felt. X-rays will not show a Morton’s neuroma, but may show important bony abnormalities.
Changing to shoes with more space in the toes, and reducing running usually helps. In addition, medications called non-steroidal anti-inflammatory medications (NSAIDs for short) may be recommended. Some of the more commonly prescribed of these include medications such as Ibuprofen, Naprosyn and Celebrex. Orthotics or toe spreaders may relieve pressure, and physical therapy may reduce pain. If unsuccessful, cortisone shot may be helpful. In resistant or very painful cases, surgery to release the nerve may be recommended.