Morton's Neuralgia – Causes, Symptoms, and Effective Treatment Methods
Do you suffer from nerve pain in your foot, forefoot pain, or a burning sensation in your foot or toes? At Laufgsund in Winterthur and the Zwicky Areal in Dübendorf/Wallisellen, we offer personalized solutions such as shoe consultations, insoles, and physiotherapy to alleviate your discomfort. Read on to learn how we can help you.
What is Morton’s Neuroma?
The Anatomy of the Foot: Where Does the Problem Occur?
Morton’s Neuroma affects the nerve running between the metatarsal bones in the forefoot—most commonly between the third and fourth toes. Persistent pressure or repeated friction irritates the nerve, leading to painful nerve compression. This results in symptoms such as sharp pain, a burning sensation, or numbness in the forefoot, often associated with wearing tight shoes or excessive strain.
Morton’s Neuroma vs. Other Foot Pain: Differences Explained
Not all forefoot pain is the same. While other foot issues like arthritis or heel spurs target joints or tendons, Morton’s Neuroma specifically affects the nerves, frequently causing a burning sensation or numbness. Many people also describe the sensation as if their sock is bunched up or doubled inside the shoe, even when this isn’t the case.
The 3 Most Common Symptoms of Morton’s Neuroma
Burning Pain
Why it occurs and how it feels.
Burning pain often results from irritation or damage to the nerves in the foot. Causes may include overuse, misalignments, pressure from improper footwear, or conditions such as neuropathy. It typically manifests as a sharp or burning pain, often starting in the ball of the foot and radiating into the toes.
Numbness and Tingling
Early warning signs you shouldn’t ignore.
Another symptom is a sensation of numbness or tingling in the forefoot, especially after prolonged activity or when wearing tight shoes.
The Shoe Factor
Taking What Causes Morton’s Neuroma?
Tight or poorly fitting shoes can severely compress the nerves in the foot and significantly worsen the symptoms. High heels or narrow shoes, in particular, exert pressure on sensitive areas and promote nerve irritation, often leading to burning or sharp pain. Many people experience noticeable relief when they remove their shoes and allow their feet more space.
What Causes Morton’s Neuroma?
Key Causes of Morton’s Neuroma: Tight Shoes, Overuse, and Foot Misalignments
Tight shoes, especially those with high heels, are among the most common causes of Morton’s Neuroma, as they significantly compress the forefoot and put pressure on the nerve. Additionally, excessive strain from activities like running or dancing, which repeatedly stress the forefoot, contributes to the development of the neuroma. The repeated mechanical stress and overexertion of the feet can irritate and thicken the nerve.
Foot misalignments, such as flat feet or splayfoot, also play a role by disrupting the natural pressure distribution in the foot. This imbalance leads to excessive stress on specific areas of the foot, increasing pressure on the nerve and raising the likelihood of inflammation and nerve damage.
How Is Morton’s Neuroma Diagnosed?
Clinical Examination: What Happens During an Appointment?
During a clinical examination, targeted pressure is applied between the metatarsal bones to determine if the pain associated with Morton’s Neuroma can be triggered. This is often combined with a "squeeze test," where the forefoot is compressed to see if it provokes typical symptoms such as burning pain or numbness. The foot is also examined for misalignments like flat feet or splayfoot, which could put stress on the nerve.
At our clinic, we also analyze gait to identify mechanical misalignments. Using pressure measurements and assessing footwear, we check for external factors that may irritate the nerve and exacerbate symptoms.
Differential Diagnosis: What Other Foot Issues Could It Be?
The symptoms of Morton’s Neuroma can also be caused by other foot problems, making precise evaluation essential. For instance, it may be confused with capsulitis, an inflammation of the joint capsule in the forefoot area, which can also cause pain and swelling. Another common diagnosis with similar symptoms is metatarsalgia, which causes general pain in the forefoot without involving a specific nerve. Additionally, arthritis in the metatarsal joints could cause pain, especially in older patients. A thorough clinical examination is therefore crucial to distinguish between these conditions and establish the correct treatment plan.
Imaging Techniques: How MRI and Ultrasound Aid in Diagnosis
Imaging techniques such as MRI and ultrasound are used when a clinical examination is insufficient or when a more precise diagnosis is needed. These methods provide detailed insights into tissues and can help identify inflammation or nerve damage. They are particularly useful for persistent symptoms (following treatment) to confirm the diagnosis and determine the best treatment option.
Treatment Options for Morton’s Neuroma
Conservative Therapy: First Steps to Relieve Pain
- Orthopedic Insoles: Custom-made insoles can help reduce pressure on the affected nerve, correct potential foot misalignments, and alleviate symptoms associated with Morton’s Neuroma. Tailored insoles minimize friction and pressure on the nerve, relieving the neuroma and allowing it to regenerate. For non-chronic cases, such insoles can even contribute to complete recovery. However, the healing process of a neuroma is slow and may take up to nine months. Fortunately, significant symptom relief is often noticeable within a short time. It is important to choose shoes that provide enough space for the insole, feature a removable insole, and have no high heels to maximize the benefits.
- Shoe Consultation: Treatment for Morton’s Neuroma often begins with adjusting footwear. It is recommended to wear wide-fitting shoes with a stable sole. A sturdy sole reduces forefoot strain during walking, thereby lessening nerve compression. Avoiding high heels is also advisable, as they shift most of the body weight onto the forefoot, exacerbating nerve irritation. Orthopedic shoes can also provide relief; at our clinic, we offer suitable models from MBT and Anova, which provide optimal comfort.
- Physiotherapy & Exercise Recommendations: Physiotherapy plays a vital role in treating Morton’s Neuroma by helping to strengthen the foot muscles and improve circulation. Targeted foot exercises reduce pressure on the affected nerve and distribute the load more evenly. Strengthening and stretching exercises for the foot muscles, such as toe curling or massaging the sole of the foot, enhance flexibility and stability. These exercises also stimulate circulation in the affected area, helping to reduce inflammation and accelerate healing. Our physiotherapists can recommend personalized exercises that not only relieve acute symptoms but also support long-term foot health.
Surgical Intervention: When Surgery Becomes Necessary
If conservative methods are insufficient, surgical intervention may be required to relieve the compressed nerve. For more information, please visit the InMotion website.
Long-Term Tips for Preventing Morton’s Neuroma
- Wear shoes with a wide toe box, stable soles, good cushioning, and no high heels. Brands like MBT and Anova offer ideal solutions.
- Regular stretching and strengthening exercises improve foot health. Practice toe curling and massage the sole of your foot to strengthen the muscles and enhance circulation.
- Avoid sports that place heavy strain on the forefoot. Swimming or cycling are gentler alternatives.
- Choose shoes with removable insoles to accommodate custom-made orthotics for existing foot misalignments.
Our custom-fitted insoles, foot exercises, and proper shoe selection can make daily life significantly more comfortable.
Other Nerve Entrapments in the Forefoot – Similar Symptoms, Similar Treatment
Additional Nerve Entrapments in the Intermetatarsal Space
In addition to Morton’s Neuroma, there are other nerve entrapments in the intermetatarsal space—the areas between the metatarsal bones. These nerve entrapments cause similar symptoms. The most common include:
- Iselin’s Neuroma: This nerve entrapment affects the space between the fourth and fifth metatarsal bones.
- Heusser’s Neuroma: This nerve damage typically occurs between the second and third metatarsal bones.
- Baxter’s Neuroma: A less commonly known nerve issue that manifests between the first and second metatarsal bones.
Similar Treatment Options as for Morton’s Neuroma
Although the affected nerves and their locations differ, the treatment options for all these forefoot nerve entrapments are similar. The key to treatment lies in reducing pressure on the affected nerve and promoting circulation.
Regardless of which nerve is affected, we offer expert advice and tailored solutions to improve your foot health.
Conclusion: Treatment and Prevention of Morton’s Neuroma
Morton’s Neuroma can be effectively treated with the right combination of orthotics, proper footwear, exercise recommendations, and targeted physiotherapy. Visit Laufgsund in Winterthur or the Zwicky Areal in Dübendorf/Wallisellen to sustainably improve your foot health.