Mortons Neuroma

Not quite a twinkle in your toes….

When you think about it, our feet take a real pounding. They are usually only around 20-30cm long, but support the whole weight of our body! On any given day, they walk around 4000 to 6000 steps, they become two sizes larger when we stand due to the force of the weight of our bodies, which is 3 times our body weight when we are running, and over the course of the day the force on them equals roughly the weight of a fully loaded cement truck. Combine this with the fact that there are 26 bones and 8000 nerves in the foot, and is it any wonder we often have problems!

One particularly uncomfortable problem is Mortons Neuroma. This painful condition affects more women than men, usually around the middle of their life.

What Exactly Is Mortons Neuroma?

Mortons Neuroma is a peroneal fibrosis – an irritation or inflammation of the sheath surrounding one of the intermetatarsal plantar nerves leading to your toes. It normally happens between the third and fourth toe. Generally, it causes a sharp or burning pain in the ball of the foot, and can also lead to feelings of stinging, burning and numbness in the toes. You may feel like you have a small stone in your shoe.

What Causes it?

There are a number of things that can cause this painful condition:

1. High heels, especially on shoes with narrow toes. The combination of the slope of the foot and the pressure of the narrowing toe space create pressure that causes inflammation.
2. High Impact sports – like running or jogging; or sports where cramped shoes are worn, like skiing or rockclimbing.
3. Foot structure – people with bunions, hammer toes, flat feet or very high arches, poor foot arch control and over-pronation (rolling in) of the foot are more prone to this condition.

How Do you Treat it?

If you have had this sort of pain in your foot for more than a couple of days, and rest doesn’t resolve it – see a Podiatrist. The causes of your condition will be identified and a treatment plan developed. Treatment will generally follow three stages:

1. Pain relief and Reduction of Irritation
   This will include avoiding high heels and narrow-toed shoes and reducing high impact sports to avoid continued irritation. Anti-inflammatories may be recommended, along with metatarsal domes in your shoes.
2. Restore Function
   If structural issues such as bunions or hammer toes are involved, recommendations on how these should be managed will be made. Custom made orthotics will possibly be recommended, particularly if flat feet or over-pronation is involved. Joint mobilizing exercises may be prescribed.
3. Prevent Recurrence
   Monitoring of shoes and the impact of exercises and regular checking of orthotics or shoe inserts will help avoid a recurrence of the problem.

In very rare cases surgery is required if conservative treatments do not solve the problem.

If you have been suffering from a pain in the ball of your foot, call to make an appointment with our Podiatrist for an assessment of your condition.