Morton’s neuroma is a benign thickening of the tissue around a nerve in your foot usually that between the third and fourth metatarsals (the bones in the forefoot behind your toes) but can occur between the second and third.

Morton’s neuroma causes a burning/throbbing pain round the area, often radiating to the toes with associated tingling or numbness.

Neuromas may occur in response to irritation, the nerve being ‘squeezed’ between the metatarsal bones, and often is caused by excessive pressure from tight fitting footwear (e.g. high heels with a tapered toe box), or an underlying stress such as forefoot hypermobility (excessive movement), secondary to alterations in the normal mechanics of the foot. It can also occur for unknown reasons.

Pain and discomfort will increase with continued repetitive high impact activity or anything that will compress or irritate the nerve. There are no visible signs of a Neuroma but on examination a ‘click’ can be felt between the metatarsal bones and can aid diagnosis.

Treatment
Start simply by changing your footwear by lowering the heel and avoiding slip on footwear that increase effort in your forefoot.

Rest the foot as much as possible and avoid high impact activity or reduce your training programme.

To alleviate symptoms a simple insole or orthotic may be required if an underlying foot function problem is found on gait analysis.

If these conservative approaches do not work surgery is one option, often in combination with orthotics to prevent reoccurrence.