Morton's neuroma is an injury to the nerve between the toes, which causes thickening and pain. It commonly affects the nerve that travels between the third and fourth toes.
Tingling in the space between the third and fourth toes
Toe cramping
Sharp, shooting, or burning pains in the ball of your foot (and sometimes toes)
Pain that increases when wearing shoes or pressing on the area
Pain that gets worse over time
In rare cases, nerve pain occurs in the space between the second and third toes. This is not a common form of Morton's neuroma, but treatment is similar.
Signs and tests
Your health care provider can usually diagnose this problem by examining your foot. A foot x-ray may be done to rule out bone problems. MRI or high-resolution ultrasound can successfully diagnose Morton's neuroma.
Nerve testing (electromyography) cannot diagnose Morton's neuroma, but may be used to rule out conditions that cause similar symptoms.
Blood tests may be done to check for inflammation-related conditions, including certain forms of arthritis.
Treatment
Nonsurgical treatment is tried first. Your doctor may recommend any of the following:
Padding and taping the toe area
Shoe inserts
Changes to footwear (for example, shoes with wider toe boxes)
Anti-inflammatory medicines taken by mouth or injected into the toe area
Nerve blocking medicines injected into the toe area
Other painkillers
Physical therapy
Anti-inflammatories and painkillers are not recommended for long-term treatment.
In some cases, surgery may be needed to remove the thickened tissue. This can help relieve pain and improve foot function. Numbness after surgery is permanent, but should not be painful.
Expectations (prognosis)
Nonsurgical treatment does not always improve symptoms. Surgery to remove the thickened tissue is successful in about 85% of cases.
Complications
Morton's neuroma can make walking difficult. Persons with this foot condition may also have trouble performing activities that put pressure on the foot, such as pressing the gas pedal of an automobile. It may hurt to wear certain types of shoes, such as high-heels.
Calling your health care provider
Call your health care provider if you have persistent pain or tingling in your foot or toe area.
Prevention
Avoid ill-fitting shoes. Wear shoes with a wide toe box.
Davies AM, Grainger AJ. Techniques and imaging of soft tissues. In: Adam A, Dixon AK, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 45.
Review Date:
6/6/2011
Reviewed By:
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
