Have Pain in the Ball of Your Foot? It Could Be Morton’s Neuroma

morton's neuroma, bottom of feet, ball of foot pain

If you have persistent pain in the ball of your foot, like you’re constantly standing on a sharp-edged pebble, it’s likely that you’ve developed Morton’s neuroma.

What is Morton’s neuroma?

A neuroma is a benign (non-cancerous) growth of inflamed tissue in and around a nerve. A Morton’s neuroma is usually located between your third and fourth metatarsal bones. (The metatarsals are the long bones that run along the top of your foot. They connect your toes to your ankles.)

The tingling and/or numbness that generally accompany the sensation of standing on gravel make Morton’s neuroma hard to ignore. Professional treatment is usually required.

What causes Morton’s neuroma?

morton's neuroma, ball of foot nerve pain

Morton’s neuroma

Inappropriate footwear is often the cause of Morton’s neuroma. Shoes that are too tight, or that do not provide sufficient arch support, can lead to this painful condition.

When women suffer from Morton’s neuroma, high heels are the primary culprit. High heels first force the foot into an unnatural heels-up position, and then the tight toebox compresses the metatarsals together.

The convergence of these forces can cause the ligament that runs across the heads of the metatarsals to become entangled with the nerve between the third and fourth metatarsals.

Morton’s neuroma also results from trauma, from the repetitive forces incurred during dedicated running, or from sports which also involve a lot of running, like soccer. Sports that require tight shoes, like skiing or rock climbing, can also cause Morton’s neuroma.

People with foot abnormalities, such as bunions, hammertoes, very high arches, or flat feet are also more likely to develop Morton’s neuroma.

Morton’s neuroma diagnosis

Typically, Morton’s neuroma doesn’t produce any visible symptom, like a lump or bony protrusion. It’s the foot pain, tingling, and/or numbness that will lead you to a podiatrist’s office, where the existence of Morton’s neuroma can be confirmed through imaging tests.

X-rays won’t show the neuroma itself, but they are useful to rule out other potential causes of your pain, like a stress fracture.

This technique uses soundwaves to create images of internal structures. Ultrasound is adept at displaying soft tissue conditions, such as neuromas.

Magnetic resonance imaging (MRI)
MRIs use radio waves and a magnetic field to visualize soft-tissue conditions.

How to treat Morton’s neuroma

As is often the case, the simplest treatment can be the most effective. If you wear high heels and you have Morton’s neuroma, stop wearing high heels. If you’re a long-distance runner or a committed soccer player, stop participating, at least until you have a treatment plan from your podiatrist.

  • For immediate relief, take anti-inflammatory medication and massage with ice. Fill a paper or plastic cup with water, freeze it, peel off the cup, and roll the ice over the painful area
  • Local anesthetics such as lidocaine can also give temporary relief
  • Cortisone injections can be helpful in reducing pain and symptoms
  • Custom molded orthotics for Morton’s neuroma can be an important component of treatment

In more acute cases, your podiatrist may prescribe wearing a walking boot during the initial healing phase.

Advanced Morton’s neuroma treatment options

Using ultrasound guidance, your podiatric surgeon first anesthetizes your foot. A small incision is then made over the affected nerve. A wand connected to the cryotherapy unit is inserted into the opening. Freezing the nerve reduces inflammation and gives the neuroma an opportunity to heal.

Alcohol Sclerosis
A specially compounded solution, with an affinity for nerve tissue, is injected into the affected area. It deadens the nerve, leaving the patient symptom-free.

Decompression Surgery
Morton’s neuroma often results when the ligament that connects the heads of the metatarsal bones is intertwined with the nerve tissue between the third and fourth metatarsal bones. A simple surgery can extract the ligament, giving the nerve enough room to reduce the inflammation and eliminate the pain.

Excision Surgery
A Morton’s neuroma excision simply removes the affected intermetatarsal nerve. When the nerve is gone, so is the pain.

What’s a stump neuroma?

Morton’s neuroma excision surgery involves some risk that the remaining nerve may partially regrow. The painful result is called a stump neuroma. The surgeons of UFAI have learned to minimize this risk by inserting the remaining nerve into the adjoining muscle. The nerve thinks it’s continuing to function normally, so a stump neuroma rarely happens.

Why choose University Foot and Ankle Institute for your foot and ankle care

If you’re experiencing foot problems, we’re here to help. Our nationally recognized foot and ankle specialists offer the most advanced podiatric care and the highest success rates in the nation. We are leaders in the research and treatment of all foot and ankle conditions.

For more information or to schedule a consultation, please call (877) 736-6001 or visit us here to make an appointment online.

Dr. Gary B. Briskin, DPM, FACFAS

As co-founder and co-director of University Foot and Ankle Institute, board-certified Dr. Gary Briskin began his medical training by serving a residency at Flint General Hospital in Michigan. Once completed, he established a practice in Century City Hospital, where he soon became chief of podiatric surgery.

Dr. Briskin is a Diplomat of the American Board of Podiatric Surgery and a Fellow of the American College of Foot and Ankle Surgeons. He also serves as an assistant clinical professor at the UCLA School of Medicine.

Latest posts by Dr. Gary B. Briskin, DPM, FACFAS

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