A Morton’s Neuroma is a painful condition affecting the forefoot caused by repetitive irritation of one of the common digital nerves.
The pain is usually located at the base of the 3rd and 4th toes. Frequently patients describe a cramping sensation that is relieved by removing the shoe and massaging the foot. There also may be burning pain radiating into the toes, sometimes associated with numbness. Some people experience a clicking sensation while walking and others report a sharp tingling or electric shocks, much like hitting your funny bone.
The diagnosis of Morton’s Neuroma is based on the history and physical examination. X-rays are taken to rule out other causes for the symptoms. In cases where the diagnosis is in question, ultrasound or MRI (magnetic resonance imaging) may be recommended.
As with many foot problems, treatment usually begins with changing footwear. A well-cushioned shoe with a broad toebox is advised. High heel, pointed toe shoes should be avoided. Biomechanical factors should be evaluated and controlled with appropriate orthotic devices. If this is inadequate, an injection of a local anesthetic with cortisone may reduce swelling and inflammation of the affected nerve.If these measures fail to resolve the symptoms, surgical excision of the nerve is recommended. This is typically done on an outpatient basis under local anesthesia with intravenous sedation.