Morton's Neuroma

A Morton’s neuroma is an exceedingly rare benign tumor involving the digital nerves at the 3rd web space.  These nerves provide sensation to the toes.  The tumor results from irritation as the nerve pass under a ligament that binds the third metatarsal to the fourth metatarsal.  This condition is commonly mistaken for metatarsalgia.

Symptoms:
The pain typically localizes to the ball of the foot and my cause burning pain or tingling involving the toes.   Can be associated with wearing a tight shoe. 

Diagnosis:
The diagnosis of  Morton’s neuroma or any other interdigital neuroma is made by history and careful physical examination including x-ray studies of the foot.  The point that distinguishes an interdigital neuroma from metatarsalgia is the location of the pain.  Neuroma pain localizes precisely between the metatarsal heads.  Pain involving the metatarsal heads themselves is not a neuroma.

Treatment:
Once the diagnosis of Morton’s neuroma is made, conservative treatment consists of off-loading the area with a metatarsal pad.  The key to the cure is alleviating the stress causing the problem.  This, most commonly, is tightness of the calf and responds well to stretching.  If operative treatment is necessary, a qualified orthopaedic surgeon can help in the decision making process and provide information regarding the risks and benefits. 

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