Having pain in the ball of your foot especially between your third and fourth toes? You could be suering from a Morton’s Neuroma.
What is a neuroma?
A neuroma is a benign growth of nerve tissue. A Morton’s neuroma is a specific type that most commonly occurs between the third and fourth toes but can also be found between the second and third toes as well. This growth or thickening of the nerve can lead to a painful condition that causes numbness, tingling and burning sensation in your toes that radiates into your foot. An additional key symptom is the feeling of something “stuck” in your shoe like a rock or pebble. Aggravating factors consist of activities that put pressure on the foot, such as standing, walking, or wearing tight shoes.
What triggers a neuroma?
It occurs when the nerve between the toes becomes compressed or irritated, leading to pain, numbness, or tingling in the aected area. Neuromas can aect anyone but they are most commonly found in highly active individuals and individuals who wear high heels.
Diagnosing neuromas
Diagnosis involves a combination of clinical evaluation, patient history, and diagnostic tests. Physical exam findings consist of feeling a tender nodule or mass, and applying pressure to the area to reproduce the pain. Another key clinical exam finding is Mulder’s click. This is a clinical sign where the examiner compresses the metatarsal joints together while simultaneously squeezing the foot in a side to side direction. If a click or popping sensation is felt and reproduces the patient’s pain, this is suggestive of a Morton’s neuroma.
While a Morton’s neuroma is primarily diagnosed based on clinical symptoms and physical examination, imaging studies can help confirm the diagnosis or rule out other conditions:
X-rays: typically normal, but they can help rule out other causes of foot pain, like fractures or arthritis.
Ultrasound: High-frequency ultrasound can be used to visualize the neuroma directly.
MRI: An MRI can reveal a mass or enlargement of the nerve.
How are neuroma’s treated?
Treatment is typically non-operatively with 95% of neuromas being managed without surgery improving with non-operative measures.
Surgery is indicated when symptoms have not improved after conservative options have been exhausted and there is confirmation of a neuroma with advanced imaging like ultrasound or MRI.
What could be mistaken for a Morton’s Neuroma?
- Metatarsalgia
- Pre-dislocation syndrome/Plantar Plate ruptures Stress Fractures
- Arthritis
- Tarsal Tunnel Syndrome
If you are having pain in the ball of your foot it is important to get it checked out as pain should never be ignored. Given the various conditions that can mimic neuromas, it is important to see a foot and ankle specialist who can help properly diagnose and treat your foot and ankle conditions. Come see us at District Foot & Ankle to ensure you are getting the proper diagnosis and treatment so you can get back to a healthier you today!