What Is Morton’s Neuroma?

Morton’s neuroma, also known as interdigital neuroma and sometimes referred to as plantar neuroma, is not a true tumor. Instead, it is a thickening of the tissue surrounding one of the digital nerves that run between the metatarsal bones in the forefoot. As the nerve passes beneath the ligament connecting the toe bones, repetitive pressure or irritation can cause inflammation and nerve enlargement, leading to pain and sensory changes.

The exact cause of Morton’s neuroma is not fully understood, but nerve entrapment and compression are believed to play key roles in its development. There are typically no outward signs such as visible lumps or skin discoloration.

Common Causes and Risk Factors

Several factors can contribute to the development of Morton’s neuroma, including:

• Wearing tight, narrow or high-heeled shoes that compress the forefoot
• Repetitive forefoot stress from activities such as running, jumping or prolonged standing
• Foot structure abnormalities, including flat feet, high arches or abnormal toe alignment
• Biomechanical issues that increase pressure on the forefoot
• Previous foot injuries or trauma

High-heeled or narrow shoes may worsen symptoms, particularly during walking or other weight-bearing activities. These factors increase compression of the nerve and surrounding tissues, resulting in inflammation and irritation.

Symptoms of Morton’s Neuroma

Symptoms of Morton’s neuroma often develop gradually and tend to worsen with activity. Common symptoms include:

• Sharp, stinging or burning pain in the ball of the foot, often behind the third and fourth toes
• Pain that radiates into the toes
• Numbness or tingling in the toes
• A sensation of standing on a small object or a wrinkle in the sock
• Temporary relief when shoes are removed or the foot is massaged

Symptoms usually worsen over time if untreated and may begin to interfere with walking and daily activities.

How Morton’s Neuroma Is Diagnosed

Diagnosis begins with a physical examination and a thorough foot and ankle evaluation. OrthoTexas specialists assess:

• Location and pattern of pain
• Foot structure and biomechanics
• Areas of tenderness or nerve irritation
• Gait mechanics and weight distribution

Imaging studies such as ultrasound or MRI may be used to confirm the diagnosis or rule out other causes of forefoot pain. Accurate diagnosis is essential to developing an effective treatment plan.

Non-Surgical Treatment Options

Most cases of Morton’s neuroma respond well to nonsurgical treatment, particularly when addressed early. Treatment options may include:

• Footwear modification to reduce forefoot compression
• Custom orthotics or metatarsal pads to offload pressure from the affected nerve
• Activity modification to reduce repetitive stress
• Anti-inflammatory medications when appropriate
• Corticosteroid or other targeted injections to reduce inflammation and pain

Many patients experience relief by wearing shoes with low heels, wide toe boxes and supportive inserts. Early diagnosis and treatment reduce the likelihood of long-term complications.

When Surgery May Be Recommended

Surgery may be recommended when conservative treatments fail to provide lasting relief and symptoms significantly affect quality of life. Surgical options for Morton’s neuroma may include:

• Ligament release to relieve pressure on the nerve while preserving sensation
• Neuroma excision, where the affected nerve segment is removed

Surgical treatment has a high success rate, though a small percentage of patients may experience symptom recurrence. In cases where the nerve is removed, permanent numbness in the affected toes may occur. Surgical recommendations are individualized based on symptoms, activity level and response to nonsurgical care.

Prevention of Morton’s Neuroma

Preventive strategies focus on reducing pressure on the forefoot and nerves. Wearing shoes with a wide toe box, avoiding high heels, choosing cushioned footwear and maintaining a healthy weight can help lower risk. Limiting activities that place repeated stress on the ball of the foot may also reduce irritation.

Potential Complications

If left untreated, Morton’s neuroma can lead to chronic pain, persistent numbness and nerve damage. Ongoing symptoms may alter gait mechanics, increasing stress on other joints and raising the risk of additional foot or ankle problems. Early evaluation and treatment are important to prevent long-term complications.

Recovery and Rehabilitation

Recovery depends on the type of treatment performed:

• Nonsurgical care often allows patients to continue most activities with modifications
• Surgical treatment typically involves a short period of limited activity, followed by gradual return to walking and normal footwear

Adhering to post-treatment instructions and follow-up care is essential for optimal healing.

Expert Morton’s Neuroma Care at OrthoTexas

Morton’s neuroma can significantly affect comfort, mobility and daily function if left untreated. The foot and ankle specialists at OrthoTexas provide comprehensive diagnostic expertise and a full range of nonsurgical and surgical treatment options tailored to each patient’s needs.