Morton's neuroma is a painful foot condition that affects one of the nerves between the toes.
It's also known as Morton's metatarsalgia or interdigital neuroma.
In Morton's neuroma, a nerve in the foot becomes irritated and thickened, which can cause severe pain.
The condition can occur in one foot or both feet. It usually affects the nerve between the third and fourth toes, but sometimes the second and third toes are affected.
Morton's neuroma can occur at any age, but most often affects middle-aged women. This may be because women tend to wear tight or high-heeled shoes that can put pressure on the feet.
It's also increasingly seen in runners, possibly because of the increased pressure on the toes that occurs when running.
Symptoms and Diagnosis
You may initially experience a tingling sensation in the space between your toes, which gets worse over time. This eventually develops into a sharp shooting or burning pain in the ball of your foot or at the base of your toes. There may also be some numbness in your toes.
The pain is often worse when walking or wearing shoes that squash the feet. Some people describe walking with Morton's neuroma as feeling like there's a small stone stuck under your foot. Removing your shoes and rubbing your foot may reduce the pain.
Initially apply ice to the foot for 10 to 15 minutes every hour, if possible reducing frequency as required when pain and inflammation starts to relieve. Do not apply ice directly to the skin as it may cause ice burns. Wrap in a wet tea towel or use a commercially available cold pack.
Rest from painful activities. This may initially mean staying off your feet altogether. Continuing to exercise on the foot will not allow the inflammation to reduce and the injury to heal. It is important to maintain fitness through non weight bearing exercises such as swimming or cycling or use the opportunity to work on upper body strength.
A metatarsal lift or pad is a small padded insert which is worn in shoes under the forefoot. It raises the central part of the forefoot spreading the metatarsals, increasing the space between them taking the pressure off the nerve. An orthotic insole can also be bought quite easily and does a similar job. Wearing these aids will help promote recovery but will also prevent future injury.
It is generally found that the pain and inflammation will reduce within a few days. If this is not the case and the pain continues for ever a week, you may have a more chronic problem and will need to go and see a health professional.
After the pain and swelling has reduced, you can concentrate on performing some strengthening and stretching exercises. Stretching for the lower leg, calf and achilles muscles can be done along with exercises to stretch the plantar fascia (connective tissue) along the bottom of the foot.
Manual Plantar Fascia Stretch
- Grasp your heel in one hand.
- Place your other hand under the ball of your foot and toes.
- Gently pull your forefoot and toes back toward your shin, creating a pull along the bottom of the foot.
Calf and Achilles Stretch
- Calf-plantar fascia stretch
- Sit with your legs extended and your knees straight.
- Loop a towel around the leg to be stretched. Position the towel so that it goes around your foot just under the toes.
- Hold each end of the towel in each hand, with your hands positioned above your knees.
- Pull back with the towel so that your foot stretches toward you.
- Hold the position for at least 15 to 30 seconds.
- Repeat 2 to 4 times a session, up to 5 sessions a day.
It is important to start very gradually with the strengthening exercises to ensure the nerve is not inflamed again. Strengthening exercises are aimed at maintaining and improving the arch of the foot.
The Figure Eight exercise (does not require any additional equipment.)
- Lead with your big toe and complete a figure-eight pattern with your foot.
- Move your foot through the largest range of motion that you are capable of.
- Towel Pull
- Place a towel flat on the floor.
- Put your foot on the end closest to you.
- Using your toes, pull the towel toward you.
To make this more difficult, you may put a weight on the end of the towel farthest from you.
Keep doing these exercises, even when the pain has gone as this will aid in the prevention of the injury returning.