Have you ever noticed a thick, numb feeling at the base of your middle toes? When you walk, does the area hurt? You might have a condition known as Morton’s neuroma. Experts don’t know exactly what causes this condition to develop, but you’re much more likely to get it if you are a woman and if you wear tight shoes on a regular basis. The name comes from a Dr. Morton who diagnosed the condition in the 1870s. A look at late 19th century shoe styles shows why his women patients may have had this problem!
A Neuroma by Any Other Name…
Some people claim that the condition shouldn't be called a neuroma, since the term refers to a benign tumor that grows in the outer tissue around a nerve. The problem is not that a tumor forms, but that the nerve tissue itself becomes thick and painful. There are many other names for it: Morton’s metatarsalgia, Morton’s disease, Morton’s neuralgia, Morton’s nerve entrapment, plantar neuroma, and intermetatarsal neuroma. Whatever the name, it usually involves the nerve between the third and fourth toes. As it progresses, wearing shoes and walking becomes more difficult.
The Mechanics of Morton’s Neuroma
You have five long bones in your midfoot called metatarsals that connect your toe bones to the heel area. Between them lie the plantar digital nerves that carry impulses to and from the toes. When these nerves are pinched or sustain a lot of pressure, they can become irritated and form extra cells to protect themselves, rather like your skin building up a callous.
The nerves can be pressured for many reasons: abnormal toe positions like bunions or hammertoes, undue pressure on certain areas of the foot because of flat feet or high arches, being pinched by tight shoes that don’t have enough room to let your toes lie flat and straight, or wearing high heels that force more pressure onto the ball of your foot. Anything that causes the metatarsals to displace can put stress on a nerve.
What Symptoms Do I Look For?
The first thing you may notice is a tingling feeling between your toes. They can cramp up sometimes, which can be intensely painful. The nerves may also send sharp, shooting pains into your toes, and the ball of your foot may feel burning hot when you are walking, especially in poor-fitting shoes. The pain is sporadic and may come and go, worsening with activity and improving when at rest. Occasionally, it might show up one week and disappear for months at a time. If the problem is not treated, though, the pain will continue and gradually get worse, turning into a chronic condition.
How Is Morton’s Neuroma Treated?
If you notice any of the above symptoms, come to the Palmer Clinic for an evaluation. An accurate diagnosis is essential in finding the right treatment, and we will want to rule out other more serious causes for your pain.
We always try conservative treatments first. We may recommend anti-inflammatory drugs or pain relievers to get you over a bad bout of pain, but the main thing is to address what might be causing the problem. We can show you how to pad or tape the toe area and may recommend shoe styles that will reduce the pressure on your bones. Custom orthotics are also very effective at relieving problems related to arch structure or misaligned bones.
Pain relievers or nerve blocking medications can be injected into the site of the pain. Physical therapy may be a good way to strengthen muscles to hold your foot bones in a better position and reduce pressure on the nerves. As a last resort, surgery procedures can either remove some of the tissue pressing on the nerves, or remove part of the nerve itself.
Contact the Palmer Foot Clinic in Winnipeg by calling (204) 697-0649 and let Podiatrist Iain Palmer help you find a solution to your painful toes. You can also request an appointment or more information online. We want you to enjoy life without the limitations that foot problems can cause.