Morton's neuroma is a noncancerous (benign) growth of nerve tissue. Morton's neuroma occurs in a digital nerve in your foot, often between your third and fourth toes. The condition doesn't involve a true tumor, but instead comprises a thickening of the tissue around one of the digital nerves leading to your toes.

Also called plantar neuroma, Morton's neuroma may occur in response to irritation, injury or pressure - such as may result from wearing tight-fitting shoes. But it may also occur on its own, for unknown reasons. Morton's neuroma is more common among women than among men.

Treatments commonly involve changing footwear, using arch supports or pads to help take pressure off the area, and resting your feet. In some cases doctors may recommend anti-inflammatory drugs, a cortisone injection or even surgery.

Signs and symptoms

Typically, there's no outward sign of this condition, such as a lump. Instead, you may experience the following symptoms:

• Burning pain in the ball of your foot that may radiate into your toes. The pain typically worsens with activity or when you wear tight or narrow shoes.

• Numbness in your toes.

You may not experience pain early in the day, but only after you stand or walk in tight shoes or engage in activities that place pressure on your feet.

Causes

Morton's neuroma appears to occur in response to irritation, pressure or injury to one of the digital nerves that lead to your toes. The nerve may react to the irritation, pressure or injury with a growth of thickened nerve tissue (neuroma). The neuroma results in sensations of pain, tingling or numbness that can radiate through your toes.

Factors that appear to contribute to Morton's neuroma include:

• Wearing high-heeled shoes or shoes that are tight or ill-fitting, including those that box in your feet and place pressure on your toes

• High-impact athletic activities, such as jogging, that subject your feet to repetitive trauma.

However, it's not always clear what may have caused the pressure or irritation that lead to Morton's neuroma. In some cases, Morton's neuroma may result from abnormal mechanics of the foot.

When to seek medical advice

If you experience a burning pain in the ball of your foot that's not improving, despite changing your footwear and modifying activities that may cause stress to your foot, see your doctor. He or she can examine your foot and determine whether Morton's neuroma or some other condition may be causing your pain.

Screening and diagnosis

Your doctor will have you explain your symptoms and will examine your foot. Because there's typically no outward sign of Morton's neuroma, your doctor will try to find a palpable mass or sense a clicking between the bones of your foot. He or she may want to have your foot X-rayed to rule out other possible conditions.

Treatment

Your doctor may recommend conservative treatment if your pain isn't severe, or before trying other treatments. He or she may suggest that you rest your feet, change to better-fitting shoes and take over-the-counter medications to reduce inflammation and relieve pain.

Your doctor may also recommend arch supports (orthotic devices) to relieve pressure on your feet. Arch supports can be pre-made or molded to fit the contours of your feet. Placing pads in your footwear also can help to take pressure off the painful area.

If your pain is severe or persistent, your doctor may recommend one of these other approaches:

• Cortisone injection. An injection of the steroid medication cortisone may reduce pain. Steroids are medications that reduce inflammation. However, overuse of injected steroids can lead to a number of side effects, so people usually receive only a limited number of injections. Potential cortisone side effects include weight gain, thinning of bones, high blood pressure and cataracts.

• Surgery. Your doctor may remove the growth surgically to relieve the pain.

Self-care

To help relieve the pain associated with Morton's neuroma and allow the nerve to heal, consider the following self-care steps:

• Take anti-inflammatory medications. Over-the-counter nonsteroidal anti-inflammatory medications such as aspirin and ibuprofen (Advil, Motrin, others) can reduce swelling and relieve pain.

• Change your footwear. Avoid high heels or tight shoes. To make sure that your toes aren't cramped, choose shoes with enough room in the toe box or wear sandals.

• Wear supports or pads. Arch supports or foot pads may help reduce pressure on the nerve.

• Take a break. For a few weeks, reduce activities such as jogging or aerobic exercise or dancing that subject your feet to high impact.

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