Interdigital Neuroma / Morton's Neuroma


 

This condition develops when one of the nerves running along the sole of the foot becomes squeezed, or inflamed between two of the bones of the foot (metatarsals).

 

Common Causes

Usually related to poor shoe wear, or increase in running/standing. When the toes and foot are unnaturally squeezed, there is pressure created on the nerves in the foot. The nerve becomes chronically thickened and inflamed.

 

Symptoms

Pain in the ball of the foot, often described as burning, or numbness, that may radiate into the toes. The space between the third and fourth toes is most common, but may occur in the space between the second and third toes as well.

 

Physical Findings

Tenderness, pain, or numbness in the third or fourth webspace with direct pressure on the nerve.

 

Workup

Diagnosis is based almost entirely on history and physical examination. X-rays are usually normal. Ruling out other causes of foot pain is required.

 

Non-operative Treatment

Modification of shoewear, with a wider toe box, and good arch and metatarsal support. Orthotics may be helpful. Non-steroidal anti-inflammatory medication , and rest. A trial of a corticosteroid injection may be of both diagnostic and therapeutic benefit.

 

Surgical Treatment

Excision of the swollen nerve (neuroma) is generally curative, also mild numbness between the involved toes may result.

 

Injury Comment

Often simple, inexpensive measures can relieve this problem, before it becomes a much more difficult situation.