A neuroma is a growth of nerve tissue that can develop anywhere in the body. The most common type of neuroma in the foot is called a Morton’s neuroma. This condition affects the ball of the foot between metatarsal bones. It most often occurs between the third and fourth toes, but it can also happen between the second and third toes. While Morton’s neuroma is benign, it can become more painful over time. The longer Morton’s neuroma is left untreated, the longer recovery may take.
Most neuromas are benign, but they can be extremely painful to live with. If you suspect you have a neuroma, make an appointment with your general practitioner or a podiatrist. Only a medical professional can diagnose this condition. While many neuroma treatments are be completed at home, a physician’s diagnosis will rule out other, more dangerous diagnoses.
Morton’s neuroma is caused by the thickening of the nerve tissue in the ball of the foot. This thickening can happen over time, but it can also arise as a result of a foot injury. A Morton’s neuroma is caused by prolonged swelling, not a tumor. Neuromas can occur elsewhere in the foot, but this nerve thickening most often happens between the third and fourth toes.
Most commonly, Morton’s neuroma is caused by too-tight shoes and footwear with high heels. Wearing these types of shoes can compress and irritate nerves in the feet, eventually leading to nerve thickening. This gradual stiffening results in pain when pressure is applied.
Genetic and preexisting foot and gait abnormalities can also cause neuromas in the foot. Morton’s neuroma is most often associated with both high arches and flat feet, as well as bunions and hammer toes. Additionally, physical activity that requires repetitive motions, like running and tennis, or those that require tight shoes, like ballet and skiing, can cause Morton’s neuroma.
Morton’s neuroma symptoms include tingling, burning, or numbness around where the nerve damage occurs – typically in the ball of the foot. As the nerve damage progresses, this tingling can turn into an intense pain. Many Morton’s neuroma patients report feeling like they are standing on a marble, or as though a bunched-up sock is stuck inside their shoe. There are not typically visible signs of this type of neuroma, like lumps, because the thickening is often not enough to be noticeable. Additionally, some people with this type of neuroma do not have any symptoms.
If left untreated, Morton’s neuroma can become more painful. Morton’s neuroma symptoms often begin gradually and may go away when shoes are removed. Over time, symptoms will begin to linger after removing the shoes, and the pain can become more intense as the neuroma enlarges. In some cases, pain can last for several days or weeks.
Morton’s neuroma symptoms often increase while walking or when the ball of the foot is squeezed. The intense ball of foot pain may make it difficult for the person to walk, and they may develop a limp.
A neuroma diagnosis requires visiting a doctor, either your general practitioner or a podiatrist. The physician will conduct a physical examination during which they will feel the foot for a palpable mass between the bones. The doctor will also try to replicate the pain in the foot by applying targeted pressure. While this may be painful, it will help better determine which nerve is affected.
The doctor will also conduct a visual examination of the foot. In identifying calluses and other evidence of stress, they can more easily determine the exact cause of the pain. Your physician may also try several range-of-motion tests to rule out other potential diagnoses, like arthritis and joint inflammation.
If these tests are not enough to generate a diagnosis, the doctor may order imaging tests to rule out other causes. For example, your physician may order an X-ray to rule out stress fractures. In some cases, an ultrasound or MRI may be necessary to provide a definitive diagnosis. These tests can be especially helpful for patients with minimal symptoms.
Most neuromas will not require drastic medical treatment. While you should see a doctor at the onset of symptoms to confirm the diagnosis, most treatments can be completed at home without prescription medicine.
In most cases, time is the best treatment for Morton’s neuroma. With enough rest, the nerve thickening will often resolve on its own. As a result, treatment focuses on mitigating symptoms and slowing swelling. If you have a Morton’s neuroma, your doctor may recommend one or more of the following treatments.
Additionally, your doctor may recommend stretching, massaging the ball of your foot, and exercises to strengthen your ankles and toes. These exercises may happen in a medical setting, such as a physical therapist’s office, or at home.
In more serious cases, your doctor may recommend surgery for neuromas. Typically, this recommendation will come after a variety of other, less-invasive treatments have been tried. Common surgical options include any of the following procedures.
Some doctors may try injection therapy before recommending surgery. This Morton’s neuroma treatment involves injecting local anesthetics, corticosteroids, and/or anti-inflammatory drugs into the foot to help decrease swelling. For shorter-term pain relief, alcohol sclerosing injections may be a good option.
Your neuroma recovery time will depend on the severity of the condition. For mild neuromas, a change to more comfortable shoes is often enough to reduce pain and swelling. More serious neuromas may require medical intervention and can take several weeks to heal. As a rule of thumb, you should expect a neuroma to heal after 1 to 6 weeks, depending on the pain and the treatment option your doctor recommends.
Most people who experience neuromas do not know the exact cause of the injury. However, there are a few preventative steps people can take to decrease the likelihood of developing nerve thickening.
If your Morton’s neuroma returns after non-invasive treatments, your doctor may recommend ongoing physical therapy appointments to help strengthen your legs and ankles. But, regardless of your neuroma’s severity or frequency, you should always see a physician at the onset of symptoms. This is the only way to ensure you receive the care you need.