Morton

Morton's neuroma (also known as Morton's metatarsalgia, Morton's disease, Morton's neuralgia, Morton metatarsalgia, Morton nerve entrapment, plantar neuroma, and intermetatarsal neuroma) is a benign neuroma of an intermetatarsal plantar nerve, most commonly of the second and third intermetatarsal spaces (between 2nd−3rd and 3rd−4th metatarsal heads), which results in the entrapment of the affected nerve. The main symptoms are pain and/or numbness, sometimes relieved by removing footwear.

Signs and symptoms

Despite the name, the condition was first correctly described by a chiropodist named Durlacher, and although it is labeled a "neuroma", many sources do not consider it a true tumor, but rather a perineural fibroma (fibrous tissue formation around nerve tissue).

Symptoms include: pain on weight bearing, frequently after only a short time. The nature of the pain varies widely among individuals. Some people experience shooting pain affecting the contiguous halves of two toes. Others describe a feeling like having a pebble in their shoe or walking on razor blades. Burning, numbness, and paresthesia may also be experienced.

Morton's neuroma lesions have been found using MRI in patients without symptoms.

Causes

Anything that causes compression or irritation of the nerve can lead to the development of a neuroma. One of the most common offenders is wearing shoes that have a tapered toe box, or high-heeled shoes that cause the toes to be forced into the toe box.

People with certain foot deformities - bunions, hammertoes, flatfeet, or more flexible feet - are at higher risk for developing a neuroma. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running or court sports. An injury or other type of trauma to the area may also lead to a neuroma.

Treatment

Initial therapies are nonsurgical and relatively simple. They can involve one or more of the following treatments: changes in footwear, orthoses (foot padding and appliances), medication, injection therapy, and physical therapy.

Surgical treatment involves resection (removal) of the neuroma or release of the plantar nerve.

See also

• Foot diseases
• Podiatry

References

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