Morton’s Neuroma

The exact cause of Morton’s neuroma is not always clear, but several factors are strongly associated with its development.

• Repetitive stress on the forefoot plays a significant role. Runners and athletes who participate in high-impact sports often place repeated pressure on the ball of the foot, which can irritate the nerves over time.
• Footwear choices are another leading cause. Shoes that are too tight, too narrow, or have high heels force the toes together and create abnormal pressure in the forefoot. Wearing high heels can aggravate the condition.
• Foot deformities, such as bunions or hammertoes, can also contribute because they change the alignment of the toes and increase nerve irritation.
• Abnormal foot mechanics, including flat feet or high arches, may also shift weight unevenly and increase the likelihood of nerve thickening. In many cases, it is a combination of these factors that leads to the condition.

The symptoms of Morton’s neuroma can vary in intensity but usually follow a similar pattern.

• Sharp, burning pain in the ball of the foot is the most common sign. This pain often radiates into the nearby toes and may worsen when walking, running, or standing for long periods of time.
• Swelling and pain between the toes.
• Many people experience numbness or tingling, often described as “pins and needles” in the toes.
• A feeling of having something inside the shoe, such as a stone or wrinkle in the sock, is another common complaint.
• In some cases, people notice a clicking or popping sensation when the toes are bent or straightened.
• Symptoms often improve when shoes are removed or when pressure on the foot is relieved, but as the condition progresses, pain can become more persistent and interfere with daily activities.

Diagnosis usually begins with a detailed medical history and a physical examination performed by an orthopedic doctor. During the exam, the physician may press on the ball of the foot or squeeze the area between the toes to reproduce the pain. This type of hands-on test is often enough to confirm the diagnosis. In certain cases, imaging studies may be ordered to rule out other conditions.

X-rays do not show the neuroma itself but can detect arthritis or stress fractures that might explain similar symptoms. Ultrasound is often helpful because it can visualize thickened nerve tissue, and MRI may be used when more detail is needed. In most cases, however, a careful physical exam and discussion of symptoms provide enough information to diagnose Morton’s neuroma accurately.

Morton’s neuroma is a common problem that affects both men and women, although it is more frequently diagnosed in women, likely because of footwear choices such as high heels. Studies suggest that up to ten percent of the population may develop this condition at some point in life.

The good news is that most cases respond well to conservative treatment, especially when addressed early. With the right combination of lifestyle adjustments and medical care, many people are able to find relief and return to normal activities without ongoing pain. Untreated the condition can get worse.