You might be walking along and feel a pain near the ball of your foot, like there’s a little pebble inside your shoe. If the ache stays with you, a condition called Morton’s neuroma might be the cause.
Morton’s neuroma happens when the tissue inside your foot gets thicker next to a nerve that leads to a toe. The pressure against the nerve irritates it and causes the pain, which usually crops up between the third and fourth toes. (That’s counting the big toe as the first.)
Women are more likely than men to get Morton’s neuroma.
Why? You can probably guess: High-heeled shoes are among the main culprits, because they put pressure on the feet. The cure may be as simple as switching to shoes with lower heels.
Morton’s neuroma has no visible sign, such as a lump. So you have to go by what you feel. The first sign may be a tingling between your toes. After that:
- The tingling may get stronger as time goes on.
- You may feel shooting pains around the ball or your foot or the base of your toes.
- Your foot may feel like there’s a pebble in your shoe or a sock is bunched up. Your toes might burn or feel numb.
- The discomfort may get worse when you’re walking or wearing shoes that squeeze your feet.
- The pain tends to ease off at night.
What Makes It More Likely
Doctors don’t know exactly what causes Morton’s. It may come from the nerve to the toe being mashed, stretched, or injured. But several things can make it likelier to happen. They include:
Shoes: High heels can put pressure on your toes or the balls of your feet. Shoes that are tight or don’t fit right also can do it.
Your feet themselves: Flat feet, overly high arches, misshapen toes (“hammer toes”), or other abnormal conditions can make you more likely to get Morton’s.
When to Call a Doctor
If pain lasts longer than a few days, don’t ignore it. Switch to shoes that are easier on your feet. Don’t exercise as hard for a while or do something (like swimming) that doesn’t pound on your feet.
After that, if your feet still hurt, go to your doctor. Finding the problem fast can make it much easier to deal with.
When you go to the doctor, be ready to tell her about the pain you’re having, when it started, the kinds of shoes you wear, and your work and other activities.
Your doctor will probably first press on your foot to check for a tender spot. If you feel a sort of click between the toes, that can also be a sign of Morton’s neuroma.
An X-ray might help your doctor rule out other potential problems, such as a fracture. An ultrasound test, which uses sound waves to create images, is a good way to spot Morton’s neuroma and other conditions that involve soft tissue.
You might hear your doctor call the condition by another name -- “intermetatarsal neuroma.”
When you have Morton’s neuroma, your doctor will probably try something simple first.
Pads that fit inside your shoe and reduce the pressure on your foot may take care of you. Drugstores sell some kinds over the counter, which means that you don’t need a prescription. But your doctor may prescribe a custom-made one that has been molded to fit your foot exactly.
Foot massages and ice packs may help. If you’re overweight and lose some of those extra pounds, that may help, too.
If none of that works, your doctor might move on to:
A corticosteroid shot: The medicine in the shot may ease the irritation of the nerve.
“Decompression” surgery: If you need an operation, this procedure cuts some areas inside your foot that are near the affected area. It may reduce the pressure on the nerve. Taking out the nerve is also an option, but only if all other treatments fail.
Cold therapy: This involves applying extremely cold temperatures to the irritated nerve, which kills some of the nerve cells. People who get the cold treatment are less likely to have Morton’s neuroma come back.
Some simple precautions will help you keep problems away. They include:
- Don’t wear high heels or tight shoes for long periods.
- Buy shoes that are wide enough at the toe that they don’t squeeze.
- Choose athletic shoes with enough padding in the soles to cushion your feet when you run or play sports.