What is Morton’s Neuroma and how is it caused?
Morton’s Neuroma is a burning, sharp pain in the sole of the foot, usually between the second and third toes, sometimes between the third and fourth. “People describe it as walking on a marble or even on razor blades,” says physiotherapist Mark Buckingham from Witty Pask & Buckingham (wpbphysio.co.uk). “The pain is there from the moment they put their foot down.”
The condition can be caused by poor running technique, but the actual problem is a neuroma. “It’s a thickening of the tissue around the nerve,” says Buckingham. “Because there’s no space for this lump to go, it causes compression and pain.” Other causes include compression of the bones and ligaments in the foot and a collapsed transverse arch, one of the arches in the foot. When the transverse arch collapses, there is more pressure between the second and third toe. A tight calf can also trigger the problem. “A tight calf means your heel lift is much earlier in the stance so you have more weight for longer over the ball of the foot,” explains Buckingham. People with a claw foot – where the tips of your toes point down and force the ball of the foot into the ground – may also experience pain.
How do I treat it?
Recovery time depends on how soon you identify the problem. “If you’re walking around and you get a numb feeling in your toes, that’s early stages,” says Mark. “You have a nerve that’s starting to tell you it’s not very happy with what you’re doing. If you have got pain like razor blades in your foot and this big thick lump, you’ll need surgical intervention to get rid of it.”
For minor pain, improving your running technique and gaining better strength and control through the feet could resolve the problem. You may need an orthotic that sits underneath the middle of the foot to lift up the middle two or three metatarsals to take the pressure away from the nerve to give it a chance to recover. “If, while you’re offloading it, you’re working on your mechanics and strength, then you can wean your way off the orthotics once you have got the strength back,” says Buckingham. This process could take two or three months. A steroid injection may also be needed to calm the nerve down, but if it’s a big lump then the solution is to have it surgically removed.
Cryosurgery is also a treatment option. This relatively new and still fairly experimental procedure involves a small probe being inserted into the patient’s foot to destroy the thickened nerve tissue by freezing it. Due to the minimally invasive nature of the cryosurgery procedure, it is not necessary to administer a general anaesthetic and the procedure is clinic based. With cryosurgery, patients are typically able to get back into exercise, running and other forms of sport in just weeks.