Morton’s neuromas are a common disorder seen in the Podiatrist office. The term neuroma refers to a tumor of a nerve. The tumor is by definition a benign tumor. There are malignant tumors of nerves that go by a different name. The term tumor simply means an enlargement or growth of tissue outside of the normal range. So a neuroma is an enlargement of a nerve that can occur anywhere in the body. The reason neuromas are most often seen by Podiatrists is that they become painful in the feet due to compression of the nerve during walking.

Neuromas most commonly present as pain in the ball of the foot. This pain is often felt on the bottom of the foot. The most common location in the ball of the foot is between the third and fourth metatarsals (the bones that attach to the third and fourth digits). This pain can be accompanied by numbness, burning, and tingling. The reason that this is the most common area is that the nerve supplying sensation to the third and fourth digit runs directly under a ligament. When this ligament is stretched tight it strangles the nerve causing pain. The same phenomenon happens in the wrists and causes carpal tunnel syndrome.

The strangling of the nerve by the ligament causes the nerve to defend itself by building new tissue. This new tissue causes the nerve to have a bulbous appearance. Hence the nerve has grown larger than is normally seen. Making it a neuroma.

One way to prevent a neuroma is to prevent the ligament from becoming too tight. The tightening of the ligament often happens when the foot spreads at the ends of the metatarsals. This pulls the ligament taught to prevent further spreading. One way to prevent the spreading of the metatarsals is by wearing arch supports which hold them in a normal position not allowing them to move freely. Often the arch supports will also take pressure off of the ball of the foot, and in turn, off of the neuroma.

If the neuromas have begun a significant inflammatory process, often times shoe inserts are not adequate. In these cases seeing the Podiatrist is paramount. A number of different techniques can be used to decrease the inflammation and size of the neuroma. If the inflammation process can be stopped, then preventing the cause will prevent any further problems.

In very severe cases surgical intervention may be required. Surgery is only discussed after a significant amount of time has gone by using conservative treatments. The surgery is a minor outpatient procedure that only requires a special shoe for approximately 2 weeks after the surgery.