(Interdigital Neuroma; Intermetatarsal Neuroma)
by Rick Alan
Morton's neuroma is an inflammation of the nerves in the foot that go to the toes. Although the name includes the word “neuroma,” it is not really a tumor. It can affect any of the toes in the foot. However, it most often affects the nerves that run between the third and fourth or second and third toes.
Morton's neuroma is an inflammation caused by a buildup of fibrous tissue on the outer coating of nerves. This fibrous buildup is a reaction to the irritation resulting from nearby bones and ligaments rubbing against the nerves.
Irritation can be caused by:
It is unusual for more than one Morton's neuroma to occur on one foot at the same time. It is rare for Morton's neuroma to occur on both feet at the same time.
Factors that increase your chance for Morton's neuroma include:
Symptoms of Morton's neuroma include the following sensations, usually between the third and fourth or (less often) second and third toes:
The doctor will ask about your symptoms and medical history. A physical exam will be done. Initial diagnosis of Morton's neuroma is based on your description of the type and location of pain and discomfort in the foot. The diagnosis will be confirmed by:
Treatments may include:
Rehabilitation Measures to Reduce Nerve Irritation
Injection of Medication
Injecting the foot with corticosteroids mixed with a local anesthetic in order to reduce pain. Relief may be only temporary, however, if the mechanical irritation is not also corrected. Injections with other types of medications such as alcohol, phenol or even vitamin B12 are sometimes used.
Surgery to remove the neuroma may be recommended if more conservative treatment does not solve the problem. While surgery usually relieves or completely removes the symptoms, it often leaves a permanent numb feeling at the site of the neuroma.
Steps to help prevent Morton's neuroma include:
American Podiatric Medical Association
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Ontario Podiatric Medical Association
American College of Foot and Ankle Surgeons website. Available at: http://www.acfas.org/ . Accessed July 17, 2009.
Berkow R. The Merck Manual of Medical Information . New York, NY: Simon and Schuster; 2000.
Clinical Practice Guideline Forefoot Disorders Panel, Thomas JL, Blitch EL 4th, Chaney DM, et al. Diagnosis and treatment of forefoot disorders. Section 3. Morton's intermetatarsal neuroma. J Foot Ankle Surg . 2009;48(2):251-256.
Morton's neuroma. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/mortons-neuroma/DS00468 . Updated June 2009. Accessed July 17, 2009.
Scardina RJ, Lee SM. Frontera: Essentials of Physical Medicine and Rehabilitation . Philadelphia, PA; Hanley and Belfus; 2002.
Thomson CE, Gibson JN, Martin D. Interventions for the treatment of Morton's neuroma. Cochrane Database of Systematic Reviews. 2004;(3):CD003118.
Last reviewed September 2012 by Rimas Lukas, MD