What is Morton's neuroma?

A neuroma is a growth (benign tumor) that arises in nerve cells. A Morton's neuroma is a swollen, inflamed nerve located between the bones at the ball of the foot. The most common location of Morton's neuroma is in either the second or the third spacing from the base of the big toe.
What causes Morton's neuroma?
A Morton's neuroma is caused by compression of the nerve of sensation between the ends of the metatarsal bones at the base of the toes.
Improper footwear that excessively binds the forefoot can lead to Morton's neuroma.
What are symptoms of a Morton's neuroma?
A Morton's neuroma causes symptoms of metatarsalgia (pain in the ball of the foot) that feels like a "burning" sharp pain and numbness that can radiate to the nearby toes. The pain usually increases by walking or when the ball of the foot is squeezed together and decreases with massaging. This ball of foot pain may force a person to stop walking or to limp from the pain.
Diagnosis of Morton's neuroma
The diagnosis of Morton's neuroma can usually be made by the doctor when the history of pain suggests it and the examination elicit the symptoms. The foot is generally tender when the involved area is compressed, and symptoms of pain and sometimes tingling can be elicited when the sides of the foot are squeezed. Magnetic resonance imaging (MRI) or ultrasound testing can be used to confirm the diagnosis if necessary.
What is the treatment for Morton's neuroma?
Symptoms of Morton's neuroma can completely resolve with simple treatments, such as resting the foot, better-fitting shoes, anti-inflammatory medications, and ice packs. More rapid ball of foot pain relief of symptoms can follow a local cortisone injection. Symptoms can progressively worsen with time. For those with persistent symptoms, the swollen nerve tissue is removed with a surgical operation.
What is the prognosis for Morton's neuroma?
The outlook for Morton's neuroma depends on the structure of the foot and whether or not simple treatments are effective. Conservative treatments include optimal footwear, cortisone injection, and resting the foot. When surgery is performed, the outlook depends on how much residual nerve damage exists.
Is it possible to prevent Morton's neuroma?
Wearing proper footwear that minimizes compression of the forefoot can help to prevent the development of and aggravation of Morton's neuroma.

SLIDESHOW
Common Causes of Foot Pain See SlideshowRuddy, Shaun, et al., eds. Kelley's Textbook of Rheumatology. Philadelphia: W.B. Saunders Co., 2000.
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