A Mortons Neuroma is a pinching of the nerve, most often between the 3rd and 4th metatarsal heads in the foot. It's caused by a fibrosis around the nerve tissue, however it does get named a ‘neuroma’ even though it is not really a neuroma. It is more frequent in females in their forties to sixties, suggesting that more restrictive footwear could possibly be part of the cause.
The key symptoms are shooting pains to the toes that progressively gets worse, yet it is not necessarily a shooting type of pain initially. Symptoms can vary from individual to individual with some only experiencing a numb feeling of the toe, and many just a moderate tingling to burning type pains. Later there is frequently an excruciating pain that may be present most of the time. Most commonly it is between the 3rd and 4th metatarsal heads, but could be found between any of them. Compressing the ball of the foot from the sides might produce the symptom and sometimes a click can be felt using the finger of the other hand while squeezing the ball of the foot. This is known as a Mulder’s click.
What causes it is believed to be an impingement on the neural tissue by the adjacent metatarsal head, resulting in a ‘pinched nerve’; the most apparent being using shoes that are too restricted over the ball of the foot. Also excessive motion of the metatarsal heads may be an issue, especially during sporting exercise. Obesity is also a frequent finding in people that have a Morton’s neuroma.
Traditional treatment typically starts with advice on the correct fitting of footwear and the use of metatarsal pads or domes. The footwear has to be wide enough to stop the pinching of the metatarsal heads and ideally have a lower heel height. If that's not really useful, then a surgical removing of the neuroma is advised. Occasionally the Mortons neuroma is helped by injection therapy in an attempt to break down the neuroma and cryosurgery is also sometimes tried.