Note: Issues beyond my control have pre-empted my ability to publish for the past month. Bear with me and I’ll try to get back on track.
Morton’s neuroma is pain associated with a nerve inflammation usually affecting the third and fourth toes. It will sometimes be felt between the second and third toes. The nerves running between the metatarsal heads and the toes have become inflamed and irritated as they are squeezed at the base of the toes. The painful, swollen nerve is called a neuroma. There is typically tingling, burning, or a pins-and-needles sensation that radiates to the end of the toes. Some people describe the sensation as walking on a pebble. If you press with your thumb at the base of your fourth toe and feel pain, you could have a neuroma. If untreated, scar tissue forms around the nerve and it becomes more painful.
This condition can be caused by a shoe’s tight toe box that compresses the forefoot or by the nerves being pressured by the metatarsal heads and the bases of the toes. Sports that place a significant amount of pressure on the forefoot area can cause inflammation of the nerves. As we walk or run, we come up onto our toes and this motion can cause the ligaments supporting the metatarsal bones to compress the nerve between the toes. Limiting your activities for a few days may be enough to allow the inflammation to subside.
A runner friend’s bout with Morton’s neuroma over several years led him to study treatment options. He learned of the following treatments, from the least invasive to the most. When he wrote the list, he was down to the last step before surgery.
1. Try shoes with a roomy toe box in both height and width, and make sure your socks aren’t too tight.
2. Try off-the-shelf orthotics.
3. Try a metatarsal pad like those made by Hapad.com.
4. Try deep tissue massage.
5. Try a cortisone injection—but only one due to its effect on tendons and tissues.
6. Try custom orthotics.
7. The last resort is surgery. Find a surgeon who goes in from the top of the foot to lessen recovery time and allow you to be more active during recovery.
Morton’s Neuroma should not limit your activities. There are solutions. Try one if it doesn’t work, move down the decision list. When you have tried number four, it’s time to find a podiatrist—preferably one who works with athletes.
