Mortons Neuroma: How It's Treated

What is Morton's Neuroma

The quick answer is Morton's neuroma is the thickening of the tissue around the nerve between the bases of the toes most commonly between the third and fourth toes of the foot. Most people that suffer from Morton's neuroma feel like where is a rock or pebble in their shoe when walking or standing. Some people may think they are suffering heel pain or plantar fasciitis. 

A Morton's neuroma is the thickening of the tissue around the nerve between the bases of the toes most commonly between the third and fourth toes of the foot. Morton's Neuroma

Anatomy of Morton's Neuroma

Morton’s neuroma most commonly affects the space between the third and fourth toes. It is a condition that affects one of the plantar digital nerves that run between the metatarsals in the foot. It most commonly affects the nerve between the third and fourth metatarsal bones, causing pain and numbness in the third and fourth toes.  Rarely, it can affect the nerves between the second and third toes. It can also affects the nerve between the second and third metatarsal bones, causing symptoms in the second and third toes.

Symptoms of Morton's Neuroma

  • A sharp or stinging pain between the toes when standing or walking short and long distances.
  • Pain in the forefoot between the toes.
  • The feeling of pins and needles and numbness.
  • Feeling like there is a "bunched-up sock" or a pebble or marble under the ball of the foot when standing or walking.

Causes of Morton Neuroma

People that wear inappropriate footwear is one of the biggest causes of Morton’s neuroma. Morton’s neuroma happens when one of your nerves is stretched and pinched. Other factors that may contribute to Morton’s neuroma include people with flat feet, bunions, hammertoes, and other forefoot problems. Women are 8 to 10 times more likely to get Morton’s Neuroma. Women that wear high heels frequently increases the risk of developing Morton's Neuroma. Individuals that participate in a lot of high impact sports such as jumping or running have a high risk of developing Morton's Neuroma. People that have jobs that require long hours of standing or walking are also at high risk.  It is more common, however, with hammertoes or overlapping hammertoe deformity. 

Test and Diagnosis of Morton's Neuroma

Most professional health care providers can do a basic examination of the foot to determine if you possibly have Morton's Neuroma. A foot x-ray may be performed to rule out bone problems. An MRI or ultrasound can successfully diagnose the condition especially if there is damage to the surrounding soft tissue. Blood tests may also be done to check for inflammation-related issues that might be presented during test mentioned above.

Treatments of Morton's Neuroma

Physical therapy is very common for the treatment of Morton's Neuroma. Jacksonville Orthopedic Institute provides physical therapy as an important tool to help healing and reduction of pain. The types of physical therapy that are used for Morton’s neuroma might include:

  • Stretching and Massage: This helps increase the flexibility of the affected area by loosening tight tendons and ligaments around the area.  Taking off the shoes and massaging the foot is usually a good way to decrease the pain. 
  • Toe Exercises: Muscle strengthening through toe exercises is an important part of physical therapy to minimize the effect of Morton’s neuroma.
    • Place a towel on a solid surface and use the toes to scrunch the towel under your feet.  Repeat for 3 minutes. 

Toe towel scrunches help to strengthen the intrinsic muscle and toes flexors in the feet.Toe towel scrunches

  • Ankle Exercises: As a result of the pain from Morton’s neuroma, the muscles that support your ankle can become weak. Strengthen exercises can strengthen the ankle, providing more stability and lessen the chances of further injury especially if your are standing or walking for long periods.

Ankle Eversion with T-band: repeat 20 x

T-band ankle eversion exercises strengthen the muscles in the outside of the leg and ankle/foot.T-band ankle inversion

Ankle Inversion with T-band: repeat 20 x

T-band ankle inversion helps to strengthen the muscles in the inside of the leg and ankle and support the medial arch.T-band ankle inversion

Ankle Plantar Flexion with T-band: repeat 20 x

Plantar flexion exercises help strengthen the calf muscles. T-band ankle plantar flexion

Ankle Dorsal Flexion with T-band: repeat 20 x.

T-band ankle dorsal flexion helps to strengthen the muscles in the front of the lower leg.T-band ankle Dorsal flexion

Prevention of Morton Neuroma

The best way to decrease the symptoms of Morton's neuroma is to avoid wearing high-heeled or narrow-toed shoes. We advise wearing roomy, comfortable shoes with adequate padding in the ball of the foot. Also, the application of ice packs to the inflamed area will also help decreasing pain an inflammation. Also if your symptoms of Morton's Neuroma are bad at maybe advisable to lay off standing and walking for long periods help with decrease pain while decreasing inflammation.  If you would like to learn more about other toe injuries, please read this article.

Book an Appointment with The Jacksonville Orthopaedic Institute Today!

JOI Physicians continue to offer online new patient appointments. This is another option to make it more convenient to make new patient appointments with less phone hold times. Follow the link below to select your JOI MD and schedule online.

You can still call 904-JOI-2000 to make new patient JOI Physician Appointments if that is your preference.

To make appointments with JOI Rehab, please call 904-858-7045.

By: Matt Paulus, MS, ATC, Site Coordinator


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