Common Causes of Foot Pain: Morton's Neuroma
We often take our feet for granted.
That is... until something goes wrong with them.
Our feet are the foundation of our body and they take us where we want to go. When this vital body component is hurting, our mobility becomes problematic and it can negatively impact our body's structure and balance.
I see many patients with foot pain. In otherwise healthy individuals this problem is usually one of two problems: plantar fasciitis or Morton's Neuroma.
In Part I of this blog, we covered the symptoms, causes and treatment of plantar fasciitis.
Part II of this two-part blog will discuss the cause, care and prevention of Morton's Neuroma.
What is Morton's Neuroma?
Symptoms of Morton's Neuroma
Morton's Neuroma is a pain or, less commonly, a numbness at the base of the third and fourth toes (middle two toes nearest the little toe) that extends into the tips of those toes. Often, my patients report that they feel like they are stepping on stone at this particular part of the ball of the foot. Or, though the skin looks normal, they feel like they have a large corn in this area. In fact, the problem lies deep in the foot, between the bones.
In this area of the feet, stick-like bones called metatarsals line up, projecting internally from the toes. Between these bones are bundles of a vein, an artery and a nerve that go on to service the toes. Also between these bones, are tendons. If the biomechanics of the foot are not correct, this area has the highest propensity to become inflamed and, in turn, swollen. When this occurs, the swelling can irritate the near-by nerves causing pain and/or numbness. Again, there are no visible outward findings in a Morton's Neuroma such as swelling or a bump.
The symptoms of a Morton's Neuroma can come on suddenly or gradually.
Risk factors or Causes of Morton's Neuroma
I had an unfortunate experience with a Morton's Neuroma soon after sanding my hardwood floors in stocking feet (lesson learned).
Sports and Morton's Neuroma. Certain sports or activities that pose significant impact on the feet can serve as a risk factor for a Morton's Neuroma. To worsen the situation, shoe wear for some sports cram the metatarsals together.
Examples of such sports are:
High Heeled Shoes and Morton's Neuroma. Sometimes style is the culprit with the use of high heal shoes. Such shoe wear hoists the heal-side of the foot up and uses gravity and the weight of our body to push the foot into a tapered point.
Foot Deformities and Morton's Neuroma. Lastly, deformities of the foot can predispose to a Morton's Neuroma. A flattened arch is the most common example. Other predisposing deformities include bunions (prominent bump at the base of the big toe) and hammer toes (abnormally curled toes).
Treatment Options for Morton's Neuroma.
The biggest factor in treating a Morton's Neuroma is removing the causal factor if identified.
- Rest for Morton's Neuroma. Taking a break from higher impact activities until the symptoms improve is paramount to improvement. This should be no more than a few weeks.
- Shoes for Morton's Neuroma. Treat the feet well by using proper footwear. Address foot deformities with shoes that are kind to your feet. Such shoes are made of a durable material (like leather), have decent arch support, have at least four shoelace eyelets and have a durable heel cup.
- Avoiding Bare Feet with Morton's Neuroma. Avoid going barefoot as much as possible.
- Ice for Morton's Neuroma. After activity, try applying ice to the sore spot for up to 20 minutes.
- Anti-Inflammatory Meds for Morton's Neuroma. Over-the-counter anti-inflammatory medications can also help.
- Steroids for Morton's Neuroma.Less conservative measures in treatment include a steroid injection (a potent anti-inflammatory) to the place where the swelling is present.
- Surgery or Liquid Nitrogen for Morton's Neuroma. Rarely, and as a last resort, the nerve is surgically decompressed, treated with liquid nitrogen or even removed.
See a doctor if the symptoms worsen or fail to improve.
Foot pain can be a definite nuisance, slowing us down and starting us down a path of unhealth. Morton's Neuroma is a common cause of foot pain. Many times, issues in our lifestyle can point to the cause. Avoidance along with measures to reduce the deep-seated inflammation are important in resolving this condition