Morton Neuralgia

What is Morton Neuralgia

Morton neuralgia is foot pain that affects the ball of the foot and the area near the toes. Morton neuralgia occurs when part of a nerve in the foot (digital nerve) is under too much pressure (compressed).

When this happens over a long period of time, the nerve can thicken (neuroma) and cause pain. Pain usually occurs between the third and fourth toes.

Morton neuralgia can come and go but may get worse over time.

What are the causes?

This condition is caused by doing the same things over and over with your foot, such as:

  • Activities such as running or jumping.
  • Wearing shoes that are too tight.

What increases the risk?

You may be at higher risk for Morton neuralgia if you:

  • Are female.
  • Wear high heels.
  • Wear shoes that are narrow or tight.
  • Do activities that repeatedly stretch your toes, such as:
    • Running.
    • Ballet.
    • Long-distance walking.

What are the signs or symptoms?

The first symptom of Morton neuralgia is pain that spreads from the ball of the foot to the toes. It may feel like you are walking on a marble. Pain usually gets worse with walking and goes away at night. Other symptoms may include numbness and cramping of your toes. Both feet are equally affected, but rarely at the same time.

How is this diagnosed?

This condition is diagnosed based on your symptoms, your medical history, and a physical exam. Your health care provider may:

  • Squeeze your foot just behind your toe.
  • Ask you to move your toes to check for pain.
  • Ask about your physical activity level.

You also may have imaging tests, such as an X-ray, ultrasound, or MRI.

How is this treated?

Treatment depends on how severe your condition is and what causes it. Treatment may involve:

  • Wearing different shoes that are not too tight, are low-heeled, and provide good support. For some people, this is the only treatment needed.
  • Wearing an over-the-counter or custom supportive pad (orthotic) under the front of your foot.
  • Getting injections of numbing medicine and anti-inflammatory medicine (steroid) in the nerve.
  • Having surgery to remove part of the thickened nerve.

Follow these instructions at home:

Managing pain, stiffness, and swelling

  • Massage your foot as needed.
  • Wear orthotics as told by your health care provider.
  • If directed, put ice on your foot:
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • Avoid activities that cause pain or make pain worse. If you play sports, ask your health care provider when it is safe for you to return to sports.
  • Raise (elevate) your foot above the level of your heart while lying down and, when possible, while sitting.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Do not drive or use heavy machinery while taking prescription pain medicine.
  • Wear shoes that:
    • Have soft soles.
    • Have a wide toe area.
    • Provide arch support.
    • Do not pinch or squeeze your feet.
    • Have room for your orthotics, if applicable.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your symptoms get worse or do not get better with treatment and home care.

Summary

  • Morton neuralgia is foot pain that affects the ball of the foot and the area near the toes. Pain usually occurs between the third and fourth toes, gets worse with walking, and goes away at night.
  • Morton neuralgia occurs when part of a nerve in the foot (digital nerve) is under too much pressure. When this happens over a long period of time, the nerve can thicken (neuroma) and cause pain.
  • This condition is caused by doing the same things over and over with your foot, such as running or jumping, wearing shoes that are too tight, or wearing high heels.
  • Treatment may involve wearing low-heeled shoes that are not too tight, wearing a supportive pad (orthotic) under the front of your foot, getting injections in the nerve, or having surgery to remove part of the thickened nerve.
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