Morton’s Neuroma Treatment

Morton’s Neuroma: Everything You Need to Know

It’s happening again. There’s a sharp pain in your foot, but every time you turn it over to have a look, you find nothing: no cuts or bruises, just a burning sensation, and waves of stinging pain.

If it feels like you’re constantly standing on a small rock despite wearing comfortable shoes, you might have a condition called Morton’s neuroma or Morton’s interdigital neuroma.

What is Morton’s Neuroma ?

Morton’s neuroma is common, and it occurs when the tissue around the nerve thickens and begins to rub the nerve.

It’s sometimes called intermetatarsal neuroma because of its location on the ball of the foot, which tends to be between the third and fourth toes, occasionally between the second and third. These spots between your toes are known as your metatarsal bones, hence the name.

What are the Symptoms of Morton’s Neuroma?

The most common symptom of Morton’s neuroma is sharp pain. You might also experience the following signs that are often worsened with walking and added pressure:

• Increased gap between the third and fourth toes
• Clicking noise when moving toes
• Burning sensation
• A lack of feeling on the ball of your foot
• Numbness
• Tingling
• Difficulty walking due to the pain

Shoes that are tight in the toe box, which includes high heels that force additional pressure on your toes and balls of feet, and an increase in activity are also thought to exacerbate the pain of Morton’s neuroma.  If you think this might be happening to you, check out our video about how to tie shoes to stop toe pain.

How is Neuroma Foot Diagnosed?

Since this is a soft-tissue deformity, it will not show up on an x-ray, but it will show up on an MRI.

An MRI is often not needed as a diagnosis is usually made by placing direct pressure on the area between the toes to elicit a pain response.

As mentioned above, you might notice that you can see a gap between your third and fourth toes.

Moving your toes in specific directions may cause a clicking sensation as the enlarged nerve slides under a nearby ligament.

Causes of Morton’s Neuroma

Are you asking, “How did I get Morton’s neuroma foot?”

A neuroma is caused by irritation and rubbing of the nerve. It is similar to how a callus is formed on your skin from excessive rubbing or pressure, like when you consistently lift weights.

Think about your gait when you walk. Patients who develop a neuroma usually find that when the arch of your foot collapses, it causes the force to shift away from the big toe and onto the smaller bones of the forefoot.

The thing is that these smaller bones are not designed to handle the loads. As a result, the excess force tends to break down the tissues under them, including the nerves running between them to the toes.

As the skin around the nerve thickens, it forms something like a benign tumor, occupying more space. The bigger it gets, the more easily it rubs the skin around it, and the cycle continues.

The nerve eventually gets so big that it is sensitive to every step. It can even spread the toes, which is why you might see a gap as mentioned above.

How is Morton’s Neuroma Treated?

When treating Morton’s neuroma, your chiropractor or medical practitioner will focus on reducing the current symptoms and addressing the underlying cause. This can be accomplished with the following neuroma foot treatments:

Radial Shockwave Therapy

Radial Shockwave Therapy transmits pressure waves into your foot in the area affected by your morton’s neuroma. These waves help reduce pain immediately by hyper-stimulating the affected nerves as well as longer-term by promoting the release of neurotransmitter Substance P which is a pain mediator.   Radial Shockwave Therapy also reduces the inflammation around your interdigital nerve by enhancing localized mast cell activity.   The radial shockwave therapy treatments for your morton’s neuroma go on to revitalize the area with neovascularization and procollagen synthesis to help heal the area.     Radial Shockwave Therapy Treatment for Morton’s Neuroma lasts 5-10 minutes and is scheduled a week apart.  Results vary with some patients reporting symptom reduction in 3-5 treatments.  We use non-invasive, non-surgical radial shockwave therapy in combination with custom orthotics to accelerate and promote an optimal environment for recovery.

Chiropractic Adjustments and Physical Therapy:

Functional movement assessments, muscle stretching and strengthening, along with specific chiropractic foot adjustments, are an integral part of repairing the function of your foot and healing it.

Acupuncture:

Acupuncture is a wonderful adjunct to the non-surgical treatment of Morton’s neuroma because it can accomplish so much. It can treat pain, numbness, and tingling while also reducing inflammation to promote healing.

Foot Orthotics:

The right custom-made orthotics will address your pain by correcting the cause of your foot dysfunction.

Foot orthotics are designed to support and restore full function in your feet. This restores optimal weight distribution over your forefoot while removing the abnormal pressure causing your nerve to thicken.

Your nerve can then heal and shrink back to standard size.

At Ravenswood Chiropractic in Chicago, we use Sole Supports Orthotics which you can read more about here.

Injections:

Cortisone is a treatment that can be injected into the area to control inflammation and pain.

This may help reduce the pain temporarily, but it will not fix the cause of your symptoms.

Multiple steroid injections can result in side effects such as weight gain and increased blood pressure. Abusing these injections can also interfere with proper healing, so patients are provided a limited number of injections.

Surgery:

If your Mortons neuroma does not heal with the conventional treatments described above, your doctor may discuss surgical options with you.

The surgery can be highly successful in reducing the pain that your Mortons Neuroma is causing but is generally a last resort because it comes with some risks.

The surgery involves removing both the small growth and some of your nerves. This usually causes permanent numbness in the affected toes, but the nerve will usually grow back slowly over time.

If the cause of your Mortons Neuroma is not treated, the nerve will become a “stump neuroma,” which can result in more pain than the first one.

Early intervention is essential and can make it possible to avoid the need for surgery. If surgery is needed, the use of custom-made orthotics immediately afterward can help ensure that the tumor does not come back.

What Can I Expect from Morton’s Neuroma Treatment?

With a proper diagnosis and a well-rounded treatment plan based on chiropractic, acupuncture, and effective orthotics, the prognosis is excellent.

Over 90% of cases will respond favorably to this course of treatment if addressed early enough.

Call us today at 773.878.7330 or schedule your examination online to determine the cause of your foot pain. We are located in Andersonville and accommodate same-day in office and telehealth appointments for foot pain.

References

1. Gougoulias N, Lampridis V, Sakellariou A. Morton’s interdigital neuroma: an instructional review. EFORT Open Rev. 2019;4(1):14-24. Published 2019 Jan 23. doi:10.1302/2058-5241.4.180025.