A neuroma is a noncancerous (benign) growth of nerve tissue that can develop in various parts of your body. Morton's neuroma occurs in a nerve in your foot, often between your third and fourth toes. The condition involves a thickening of the tissue around one of the nerves leading to your toes. Morton's neuroma causes a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb. Also called plantar neuroma or intermetatarsal neuroma, Morton's neuroma may occur in response to irritation, injury or pressure. Morton's neuroma may also occur for unknown reasons. Common treatments for Morton's neuroma include changing footwear or using arch supports. Sometimes, corticosteroid injections or surgery may be necessary.

Causes of Morton’s Neuroma

Doctors don't understand exactly what causes Morton's neuroma. The condition seems to occur in response to irritation, pressure or injury to one of the digital nerves that lead to your toes. The growth of thickened nerve tissue (neuroma) is part of your body's response to the irritation or injury.

Factors that appear to contribute to Morton's neuroma include:

• Wearing high-heeled shoes or shoes that are tight or ill-fitting, including those that box in your feet and place pressure on your toes
• High-impact athletic activities, such as jogging, that may subject your feet to repetitive trauma
• Injury to your foot

In some cases, Morton's neuroma may result from abnormal movement of your foot, caused by bunions, hammertoes, flatfeet or excessive flexibility. In some cases, there's no clear cause of pressure or irritation.

Signs & Symptoms of Morton’s Neuroma

Typically, there's no outward sign of this condition, such as a lump. Instead, you may experience the following symptoms:

• A burning pain in the ball of your foot that may radiate into your toes
• Tingling or numbness in your toes

At first, the pain may worsen when you wear tight or narrow shoes or engage in activities that place pressure on your foot. Over time, though, symptoms may last for days or weeks.

Diagnosis of Morton’s Neuroma

Your doctor will ask about your symptoms and examine your foot. Because there's typically no outward sign of Morton's neuroma, your doctor will try to find a palpable, tender mass. There may also be a feeling of "clicking" between the bones of your foot. Your doctor may order an X-ray of your foot to rule out other foot problems.

Treatments of Morton’s Neuroma

Treatment depends on the severity of your symptoms. Your doctor will likely recommend trying conservative approaches first. This may include resting your foot, changing to better-fitting shoes, trying foot orthotics (arch supports) and taking over-the-counter medications to reduce inflammation and relieve pain.

If your pain is severe or persistent, or conservative approaches aren't working, your doctor may recommend:

• Corticosteroid injections. Steroids are medications that reduce inflammation. An injection of a corticosteroid medication in the area of the neuroma may reduce pain. However, overuse of injected steroids can lead to a number of side effects, including weight gain and high blood pressure, so people usually receive only a limited number of injections.
• Alcohol injections. Diluted alcohol injections are a new and promising treatment option for Morton's neuroma. According to two 2007 studies in the American Journal of Roentgenology and the Journal of the American Podiatric Medical Association, alcohol injections have been shown to improve pain and decrease the size of Morton's neuroma in study participants. However, because alcohol injections are still a new therapy for Morton's neuroma, many health care providers don't yet offer this treatment.
• Surgery. Surgical removal of the growth may be necessary if other treatments fail to provide pain relief. Although surgery is usually successful, doctors often turn to surgery as a last resort, because the procedure removes both the neuroma and the nerve, which can leave permanent numbness in the affected toes.

When to seek Medical Advice

It's best not to ignore any foot pain that lasts longer than a few days. If you experience a burning pain in the ball of your foot that's not improving, despite changing your footwear and modifying activities that may cause stress to your foot, see your doctor. He or she can examine your foot and determine whether Morton's neuroma or some other condition may be causing your pain. Early diagnosis and treatment can prevent the need for surgery.