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Morton's neuroma

A neuroma or, Morton’s neuroma, is a painful condition often referred to as a pinched nerve, swollen nerve or nerve tumour

Despite the name ‘neuroma’ which can describe a benign nerve tumour, a Morton’s neuroma describes the inflammation of the tissue (sheath) that surrounds a nerve in the foot, causing it to thicken and become painful. It occurs between the long bones of the foot (metatarsals) and most commonly affects the nerve between the third and fourth toes around the ball of the foot.

What are the symptoms?

Symptoms of a Morton’s neuroma include:

  • Pain and tenderness around the neuroma

  • Swelling and redness

  • A palpable mass between the metatarsal bones that may not be visible when looking at the foot

  • Feeling like you’re walking on a pebble

  • A ‘click’ when you’re moving the bones surrounding the neuroma up and down past one another

  • Pain that is exacerbated by pinching the sides of the foot

  • Burning, pins and needles, tingling and numbness

What causes a Morton's neuroma?

A Morton’s neuroma is often caused by overloading the forefoot, with the sheath around the nerve thickening in response to this increased pressure, an injury, or general irritation of the nerve. Contributing factors can include:

 

  • Shoes that overload or cramp the forefoot such as high heels, pointed shoes and tight footwear such as in skiing and rock-climbing

  • Physical activities that place increased pressure on the ball of the foot such as in running and climbing stairs

  • Biomechanical or alignment issues of the feet and legs

  • Foot injury

  • Forefoot deformities such as bunions and hammertoes

Managing your neuroma at home

Until you’re able to see your Podiatrist, managing your painful symptoms includes offloading the area around the neuroma and avoiding any activity or object that places more pressure on the neuroma, such as tight footwear. 

 

You can rest, ice and elevate the foot to help reduce some swelling and pain. If icing, do so for no more than 20 minutes at a time every 2 hours. As the neuroma can become larger if not effectively managed, it is important to see your Podiatrist as soon as you’re able to.

How your Podiatrist can help

Your Podiatrist will perform a comprehensive biomechanical assessment and form a tailored treatment plan that is specific to the severity of your symptoms and your regular activities. This may include:

 

  • Orthotics to alleviate pressure away from the neuroma and help correct any biomechanical or alignment issues contributing to its development or persistence

  • Footwear advice to ensure your shoes are helping and not hindering recovery

  • Soft tissue techniques such as massage or acupuncture

  • Stretching to maintain good range of motion through the foot after the neuroma begins to settle

 

If the neuroma does not improve and continues to cause you pain, surgery may be indicated. Your Podiatrist will refer you appropriately.

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