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Morton's Neuroma Specialist
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
What is Morton’s Neuroma?
Morton’s Neuroma is characterised by the thickening of the tissue surrounding the digital nerve leading to the toes. This condition most commonly affects the area between the third and fourth toes.
The thickened tissue results from repetitive irritation, trauma, or excessive pressure on the foot. Unlike what the name ‘neuroma’ suggests, this condition does not entail the growth of a tumour.
Causes of Morton's Neuroma
Morton’s Neuroma arises primarily due to factors that place excessive pressure or strain on the foot, particularly the area between the toes.
- Inappropriate Footwear Choices
High-heeled and tight shoes, particularly those with a narrow toe box, can contribute to Morton’s Neuroma. These shoes may encourage a foot position that can increase stress on the toes and the ball of the foot, leading to nerve compression. - Repetitive Stress Activities
Engaging in sports or activities that involve repeated pressure on the foot, such as running or certain types of dancing, increases the risk of developing Morton’s Neuroma. The constant impact on the ball of the foot can aggravate the nerves and lead to tissue thickening. - Certain Foot Deformities
Certain foot structures and conditions, including flat feet, high arches, bunions, and hammer toes, can predispose an individual to Morton’s Neuroma. These deformities alter the normal distribution of weight and pressure on the foot, potentially leading to nerve compression. - Prolonged Pressure on the Ball of the Foot
Extended periods of pressure on the ball of the foot, such as from certain occupations or activities, can contribute to this condition.
Symptoms and Signs
The symptoms of Morton’s Neuroma are distinct and primarily affect the ball of the foot.
- Numbness and Tingling: Affected individuals often report a numbness or tingling sensation in their toes. This is a direct result of the nerve compression caused by the thickened tissue.
- Radiating Discomfort: The pain can extend into the toes, creating a discomfort that spans a larger area of the foot.
- Burning Pain in the Ball of the Foot: A prevalent symptom is a burning sensation in the ball of the foot. This pain may intensify during activities or when wearing certain types of footwear, particularly those that are narrow or have high heels. Some may experience a sensation akin to walking on a marble. This sensation is attributed to the thickened nerve tissue, which creates discomfort and pain in the affected area.
Contrary to some conditions that exhibit external physical signs, Morton’s Neuroma typically does not present visible symptoms like a lump. Paying attention to the sensations and feelings of discomfort can help ensure timely recognition and diagnosis of the condition.
Diagnosis
Diagnosing Morton’s Neuroma involves a combination of clinical examination and imaging tests.
- Physical Examination: Diagnosis typically begins with a physical examination, focusing on the ball of the foot. The foot specialist may palpate the area between the toes to identify any mass, tenderness, or a “click” sensation, which are indicative of Morton’s Neuroma. The range of motion and the presence of any bony tenderness in the foot may also be checked to exclude other causes of foot pain.
- Imaging Tests: An X-ray is often used to rule out bone-related conditions like arthritis or stress fractures. In cases where a soft tissue mass is palpable, an ultrasound or MRI may be used to ascertain its nature and the extent of the thickened nerve tissue.
Non-Surgical Treatment Options
Several non-surgical treatment strategies can be effective in treating Morton's Neuroma, especially in less severe cases.
Appropriate Footwear and Orthotic Inserts |
Switching to shoes with lower heels, a wider toe box, and adequate room across the ball of the foot can alleviate pressure on the nerve. Over-the-counter or custom-made orthotic devices, such as metatarsal pads, can also help redistribute pressure away from the nerve. These inserts are designed to fit inside the shoe and provide support and cushioning. |
Anti-inflammatory Medications |
Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, can be effective in reducing swelling and relieving pain. |
Activity Modification |
Reducing or modifying activities that exacerbate the condition, such as certain types of exercise or prolonged standing, can provide relief. |
Steroid Injections |
In cases where pain persists, corticosteroid injections may be administered to reduce nerve inflammation. |
Surgical Treatment Options
Surgical intervention may be considered when non-surgical treatments do not provide sufficient relief for Morton’s Neuroma.
Decompression Surgery
This procedure involves cutting structures around the nerve, such as the ligament binding the bones at the front of the foot. The goal is to relieve pressure on the nerve.
Nerve Resection
In more severe cases, part of the affected nerve may be surgically removed. This method aims to alleviate pain by removing the inflamed nerve tissue.
Prevention Strategies
Preventing the development or progression of Morton’s Neuroma involves addressing the factors that contribute to its onset.
- Wearing Footwear to Reduce Pressure on the Foot - Choose shoes with a wide-toe box, low heels, and adequate support. This reduces pressure on the toes and the ball of the foot, minimising the risk of nerve compression.
- Using Orthotic Devices - For individuals with foot deformities or those who require additional support, custom orthotics can provide the necessary cushioning and distribute foot pressure more evenly.
- Modifying Strenuous Activities - Engaging in lower-impact exercises and avoiding repetitive activities that strain the feet can help prevent Morton's Neuroma. Try to vary activities to reduce constant pressure on the same foot area.
- Maintaining a Healthy Weight - Maintaining a healthy weight can reduce the stress on the feet and, consequently, the risk of developing Morton's Neuroma.
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
With over 18 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.
- Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
- Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
- Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
- Master of Medicine (Orthopaedic Surgery), National University of Singapore
- Member, Royal College of Surgeons of Edinburgh (MRCSEd)
- Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Frequently Asked Questions (FAQ)
What Happens if Morton's Neuroma is Left Untreated?
Leaving Morton’s Neuroma untreated may lead to a worsening of symptoms, including increased pain and discomfort. Continual nerve compression can lead to further complications, possibly affecting future treatment options. Seeking timely evaluation and treatment from a foot specialist can help manage symptoms effectively.
How Long Does Morton's Neuroma Take to Heal?
The recovery time for Morton’s Neuroma depends on its severity and the treatment approach used. Non-surgical treatments can provide relief within weeks, but in more persistent cases, especially if surgery is required, recovery may take longer.
Can Massages Help Treat Morton's Neuroma?
Massage therapy may offer temporary relief from symptoms by reducing pressure and improving blood flow in the affected area. While it may be beneficial, it should not be used as a standalone treatment. Consulting a foot specialist can provide a treatment plan suited to individual needs.
Can You Get Morton's Neuroma in Both Feet?
While Morton’s Neuroma typically affects one foot, it’s possible to develop in both feet. If you experience the condition in one or both feet, consult a foot specialist for timely treatment and personalised care.