Have you ever experienced a stabbing pain in the ball of your foot? (Most likely, it was right around your second, third and fourth toes?) Chances are you have a Morton’s Neuroma. This is a painful condition that results from an inflamed nerve in the ball of your foot. And understanding this condition, plus how to find pain relief, is our topic today.
What is Morton's Neuroma?
A neuroma is a benign, non-cancerous growth on a nerve. (It's also described as a swollen nerve. When you develop this problem on the nerve between your third and fourth toes, it's called a Morton’s neuroma.
When you have this problem, it's painful. When you walk, your feet may feel full or swollen under the ball of the foot and toes. Some of my patients say walking with a neuroma feels like walking on a marble or a rolled up sock.
If you feel like you have to take off your shoe and rub your foot when you walk, it could be a neuroma. Lots of times, this will help relieve your neuroma pain in the early stages by moving swelling away. But soon, a simple massage won't help. And you'll notice numbness, pain or tingling in your toes. (Note: these symptoms could also mean neuropathy. So discuss any kind of footness with me or your general doctor immediately.)
What Causes Morton's Neuroma?
Lots of women have high-heels with narrow toe boxes; many also have flat feet; and plenty who have both love to run. According to research, that triple-combo is a major risk factor for this condition.
Here's the story. Like I said, neuromas form when a nerve between your toes becomes enlarged and enflamed. And that causes you to experience a burning, tingling sensation.
As I also said, Morton’s neuroma forms when the affected nerve is between the base of your third and forth toes. And there seems to be a connection to squeezing flat feet into tight shoes, before pounding them on the pavement. This can contribute to the nerve inflammation associated with neuromas.
Other risk factors include:
- High arches
- Tight Achilles tendons
- Past trauma
- Repetitive stress (something runners know lots about!)
Knowing thes risk factors, there’s a lot we can do to help prevent neuromas from forming. Most people with flat feet or high arches can find support with orthotic inserts. Of course, at one time, orthotics could only fit in clunky shoes. But, these days, you can get inserts designed to fit into your stilettos. If you have a pair for your heels and a pair for your sneakers, you'll be well protected against neuromas.
Choosing better running shoes, and taking rest days, can also prevent swollen nerves. And always treating foot injuries may also stop complications later on. (Another great reason not to walk off any foot pain!)
Diagnosing Ball of Foot Pain
I can usually diagnose a neuroma with a clinical exam. Sometimes, I can even feel the swollen nerve as a mass. Sometimes, I'll need to order an MRI or ultrasound. This can help confirm my diagnosis, and rule out other foot problems. Usually, though, I can use some simple tests during your physical exam to diagnose neuroma.
As with anything, it's easier to relieve neuroma pain with an early diagnosis. In fact, we can manage neuroma pain at home in some cases. But that's only true if you see me at the first sign of a problem.
Managing Neuroma Pain at Home
First, remember: you must see me to diagnose this condition. (And some patients will need surgery to get relief.) But many people can treat neuromas at home. We can use a combination of over-the-counter painkillers and my directions to stop your pain.
One important factor? Changing your shoes, to take pressure off the balls of your feet. I can also recommend oral anti-inflammatories that you can buy in any drug store.
Another easy (and surprisingly pleasant!) at home treatment for neuromas of the feet? Self massage!
Massage can open up space between the metatarsal bones in the ball of your foot. It can also increase circulation. And both results may reduce both pain and inflammation.For best results, try a self-massage after a hot bath or shower.
When starting your massage, focus on the ball of the foot, not the toes, since that’s the true source of the problem. Try placing your thumbs at the top of the foot and the other fingers on the bottom of the foot. Then, press and massage the bones in the ball of the foot, creating pressure on all sides of the bones.
After your massage, try some stretches. You can grab the front of your foot and pull it back towards you. This will open up space in the ball of the foot. Plus, it may relieve tight tendons that could be adding to your problem. After your massage, apply ice to the ball of your foot. This will further relieve swelling and inflammation.
Now, for many people, these at-home treatments will relieve the pain of neuromas. But if at home treatments aren’t doing the trick, you may need to explore other options.
In-Office Care for Pain in Ball of Foot
When over-the-counter drugs don't work, oral or injected anti-inflammatories and cortisone may help. For some patients, custom orthotics will do the trick. We prescripe these medical devices to take pressure off your forefoot. They can also control any gait problems that could increase your neuroma pain. And, when non-invasive treatments don't work, I may recommend surgery.
During neuroma surgery, I may reduce pressure around your nerve by operating on the surrounding ligaments. Or, I can remove the affected part of the nerve. I'll choose the best treatment based on your condition and lifestyle needs.
Have you noticed pain in the ball of your foot? Contact Dr. Andrew Schneider to schedule an immediate consulation. We can address your Morton's neuroma pain quickly and effectively. Most likely helping you avoid surgery.