When something gets on your toes’ nerves

Morton Neuroma

What is that?

Morton's neuroma is a painful disease of the nerves in the metatarsal bone.

How does this manifest itself?

Sudden shooting, burning or stabbing pain, usually between the third and fourth metatarsal heads. This acute pain is caused by an inflamed and thickened metatarsal nerve. 

Where does it come from ?

Tight or high shoes and intensive running training (overloading of the forefoot) can be the cause. A splay foot or bursitis also promote the formation of a Morton neuroma.

What happens if I don’t act here?

The inflammation of the Morton neuroma can last for a long time and flare up again and again, and occasionally even become chronic. The constant pain changes the rolling motion of the foot and thus affects the adjacent joints, from the ankle to the hip. The range of motion is restricted due to the pain, and you find it increasingly less enjoyable to move around.

If conservative measures are unsuccessful, the only option is to surgically remove the Morton neuroma. The consequences of this operation can be sensory disturbances in the area supplied by the nerves, as well as atrophy of the muscles and, as a result, an increase in splay feet and the development of claw toes. 

How do I find out if I have something like this?

If the pain is so severe that you want to take off your shoes and give your foot a rest and the pain quickly subsides as a result of this relief, then there is a high probability that you have a Morton neuroma.
MRI scans can provide information about whether a neuroma is actually present or whether the pain has another cause. However, a small neuroma is not always easy to see in MRI images. If the scan was performed without contrast medium, it can be difficult to clearly distinguish the thickening of the nerve from the soft tissue.

How do you treat this?

The first and most important measure is to reduce the contact of the painful area with the ground. Peripheral nerves are sensitive to pressure and shock, so insoles are well suited to relieving the forefoot so that the Morton neuroma is not subjected to pressure while walking.
Pads and special cushions prevent contact with the ground that is too hard and thus help to relieve pressure and help the tissue to recover. In some cases, additional point-based relief may be necessary.
Stabilizing tape bandages often bring about improvement, as does targeted foot exercises to activate the intrinsic foot muscles and thus muscular stabilization of the transverse arch. We recommend wearing barefoot shoes for a few hours at home in order to train the muscles of the foot in a natural way.

In everyday life, the shoes should have a thick, rounded sole in the ball area.

If a confirmed diagnosis does not respond to conservative measures and the quality of life is limited, then surgery should be considered.