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Karen E Anderson, DPM
Associate, American College of Foot Surgeons

Medicine and Surgery of the Foot & Ankle
Specializing In Chronic Pain Conditions

7855 Fay Ave., Suite 290, La Jolla, CA 92037 · (858) 459-3214 · Fax (858) 459-3505
5565 Grossmont Center Dr., Bldg 3, Suite 152, La Mesa CA 91942 · (619) 440-2202 · Fax (619) 440-0502

Morton's Neuroma

Definition
Morton's Neuroma is a common foot problem associated with pain, swelling and/or an inflammation of a nerve, usually at the ball-of-the-foot between the 3rd and 4th toes. Symptoms of this condition include sharp pain, burning, and even a lack of feeling in the affected area. Morton's Neuroma may also cause numbness, tingling, or cramping in the forefoot.

Cause
Morton's Neuroma is a foot condition caused from an abnormal function of the foot that leads to bones squeezing a nerve usually between the 3rd and 4th metatarsal heads. Symptoms of Morton's Neuroma often occur during or after you have been placing significant pressure on the forefoot area, while walking, standing, jumping, or sprinting. This condition can also be caused by footwear selection. Footwear with pointed toes and/or high heels can often lead to a neuroma. Constricting shoes can pinch the nerve between the toes, causing discomfort and extreme pain.

Treatment and Prevention
The first step in treating Morton's Neuroma is to select proper footwear. Footwear with a high and wide toe box (toe area) is ideal for treating and relieving the pain. The next step in treatment is to use an orthotic designed with a metatarsal pad. This pad is located behind the ball-of-the-foot to unload pressure, and relieve the pain caused by the neuroma.

Ultimately, a neuroma may be treated with a series of 2 or 3 cortisone injections or surgery. If the injections are done, they should be in conjunction with the conservative therapies such as appropriate shoe choices and/or orthotics with metatarsal pads. A cortisone injection alone does little more than temporarily relieve pain.