By Dustin L. Kruse, DPM
Dr. Thomas George Morton was a well-respected doctor, a surgery professor and lecturer, and a hospital administrator during the Civil War in the USA, but he is remembered today mainly for his work on metatarsalgia. One condition that causes this type of pain in the ball of the foot is named after him: Morton’s neuroma. It involves the nerves between your smaller toes, and can cause you a lot of discomfort.
Pinched Nerves and Burning Pain
The nerves that run between your toes help you to move them and sense when they are hot, cold, or injured in some way. Some nerves lie under the ligaments of the joint between your toe bones and metatarsals and endure a lot of pressure from your body weight.
When a nerve is pinched in this way, or between two toes that are cramped together in tight shoes, it responds by sending pain signals to your brain. It may also grow extra fibers around the nerve, rather like scar tissue, that can make it feel swollen and numb. The damage to the nerve can bring on metatarsalgia and limit your movement.
Not surprisingly, women will experience this problem more often than men—most likely because of the shoe styles they commonly wear.
Diagnosing Morton’s Neuroma
When you come in with pain under the ball of your foot, we will press on the area to see where pain is located and feel for any thick spots. We may use an X-ray to rule out stress fractures, or an ultrasound to look for soft tissue damage. We will also take a look at any foot deformities you may have, because bunions, hammertoes, and high arches or flat feet can all increase your risk of developing a neuroma.
Certain activities such as jogging, running, rock climbing, or skiing can also put pressure on this area of the foot and pinch the nerves. Wearing high heels, which concentrates all your weight on the ball of your foot and usually cramps your toes into small, pointed fronts, can also subject you to this problem.
Conservative Treatments Usually Help Neuromas
We will likely start treating this problem by advising you on better shoe choices. You need to find a pair that leaves plenty of room for your toes and has 2-inch heels or lower. They will let the toes lie flat and reduce pressure on the nerve.
If you need more relief, a custom orthotic can lift the bones and separate them to leave more room for the nerve. We may also try an injection of corticosteroid medication to reduce inflammation and swelling—and therefore pain. These conservative treatment methods will succeed a good majority of the time in relieving symptoms of Morton’s neuroma.
The Surgical Alternative
When nothing else has helped, and you still have that stinging burning pain under your forefoot with certain shoes or certain activities, it is time to talk with us about surgery. Not every person is a candidate for surgery, but possibly a simple procedure with a short recovery time could be the answer to your pain.
One procedure for Morton’s neuroma removes or releases the tissue around the nerve, and another resects the nerve itself to relieve your pain. These usually need only a short recovery time. In extremely painful cases, the nerve may be removed, but then you may always have numbness in the toes. Recovery time for this procedure will be a bit longer. We will help you consider the advantages and risks of nerve surgery to make the best decision.
Call Rocky Mountain Foot & Ankle Center in Wheat Ridge, CO, at (303) 423-2520 and set up an appointment to see one of our expert podiatrists. We will help you get to the bottom of your foot pain and find a solution that works. You can also schedule online, or at one of our other locations.
Photo Credit: Hans via pixabay.com