Book a consultation
  • Call us on

    020 7692 0675
    Mon-Fri: 8am-6pm
    (New enquiries only)

  • Find us at

    HCA UK Outpatients & Diagnostics The Shard, 32 St Thomas Street, London SE1 9BS

Click to call for new patient enquiry If you are an existing patient please call the consultant directly. You can find their direct number on their consultants page.

Home | LBO News | Morton’s Neuroma: A Lesser Known Cause Of Foot Pain

Morton’s Neuroma: A Lesser Known Cause Of Foot Pain

Morton’s Neuroma: A Lesser Known Cause Of Foot Pain

Our consultant foot and ankle surgeon, Mr Sam Singh, discusses Morton’s Neuroma – a common cause of foot pain that is most likely to affect runners or middle-aged women.

We all know of the more well-known causes of pain affecting the foot and ankle, such as Achilles tendinitis, shin splints and stress fractures. But not many will have heard of something called Morton’s neuroma.

Morton’s neuroma, also known as intermetatarsal neuroma, is the name used to describe the enlargement of one of the nerves travelling to your toes in your forefoot. It is more likely to affect women than men.

It shocks me how common they really are! Indeed, I think it’s one of the most common causes of forefoot pain – particularly in middle-aged women or runners. I probably see and treat very large numbers partly because of the demographics of my referral base, which often comprises younger athletic patients and runners. Running is a boom sport in London.

Some of the most common signs and symptoms of Morton’s neuroma include:

  • Burning, stinging, stabbing, or shooting pain in the ball of your affected foot
  • A tingling sensation between your third and fourth toes
  • Foot cramping
  • Foot numbness
  • The sensation that you are walking on a lump

metatarsal_bonesMorton’s neuromas develop between your third and fourth metatarsal bones and your toes or between the second and third metatarsal. Neuromas are benign, non-cancerous and often respond to conservative care methods.

For runners, Morton’s neuroma develops after continual pressure on the nerve or wearing inadequate footwear during a run. A narrow toe-box, along with a high heel, can contribute to the problem. That’s why it’s more of an issue in women. However, if men wear narrow toe-box shoes, it can easily develop.

Other factors that may contribute to Morton’s neuromas include:

  • Flat feet
  • Bunions, hammertoes, and other forefoot problems as they throw the weight onto the lesser metatarsals
  • Excessively high foot arches

The clinical diagnosis is usually the most effective way to diagnose neuromas. In the clinic, I try to duplicate neuroma symptoms by pressing on the involved nerve at various points and try to cause a clicking of your nerve that indicates nerve enlargement. It can be a painful manoeuvre but it often clinches the diagnosis. X-rays of your affected foot will not show a neuroma, as neuromas are made up of soft tissue. An ultrasound is the best diagnostic test.

Treatment for Morton’s Neuroma

Conservative treatment involves using footwear that allows your forefoot to spread. High heels cause neuromas by squeezing and stretching the involved intermetatarsal nerve across the ball of your foot and should be avoided as often as possible.

Test shoes before you buy them to see if they are appropriate for your feet. Select shoes that have a removable liner or insole and stand on the liner, noting the position of your foot. If your foot is wider than your liner, that shoe will irritate your neuroma by squeezing your metatarsal bones together.

You may need a metatarsal dome if wider shoes alone fail to relieve your interdigital neuroma symptoms. A metatarsal pad will help spread your metatarsal bones and reduce pressure on your affected nerve as it travels under the ball of your foot. This is important.

Other conservative care remedies include ice therapy and anti-inflammatory medications or supplements. If conservative care measures fail to resolve your problem, I may recommend a cortisone injection around your involved nerve to help reduce your swelling and inflammation.

Failing all that, a neurectomy may offer a solution. This a surgical procedure to remove the enlarged and traumatised portion of the involved nerve. The mild numbness after surgery rarely causes a patient problems and removes pain associated with the neuroma.

For more information regarding Morton’s neuroma and all other orthopaedic treatments, contact London Bridge Orthopaedics.

Our specialties

We cover all the subspecialty areas of orthopaedics

Recent articles

hip replacement

Why Do Men and Women Fare Differently After Hip Replacement Surgery?

A recent study by the University of Illinois has discovered that gender does play a role in terms of whether the outcomes from hip replacement surgery is good or poor. The study was to identify why gender affects the outcomes ...
Read more