When you have persistent pain in your foot, we know how many of your brains will start to work. You’re wondering if you will ever feel better. Or if you’ll need surgery to make a full recovery.

So let’s take a look at one condition, Morton’s Neuroma. (It's known for causing ball of foot pain.) And it's a problem where surgery is often recommended. We’ll explore the symptoms of the condition. Then, we'll review what we can do to help you feel better. Well before we start talking about surgery.


What is Morton’s Neuroma? 

If you're experiencing pain in the ball of your foot, there are several possible diagnoses. First, make sure you're not diabetic. Because diabetes can damage your nerves (neuropathy.) And that can leave you with burning or tingling pain in the ball of your foot.

Once you've ruled out neuropathy, we can explore other diagnoses. And one will likely be Morton’s neuroma: an enlarged nerve in the ball of your foot. When that enlarged nerve travels through your toes, it faces lots of pressure. Which is when you may notice pain.

Most often, the nerve located between your third and fourth toes is affected. And that's a problem, because the nerve brings sensation to your toes. So, when it rubs up against or becomes trapped by the bones and tissues in the middle of your foot, you notice symptoms. At this point, you may experience numbness, burning or tingling in your toes or forefoot. You may also experience sharp pain or even swelling in the area. It could even feel like you have a pebble or balled up sock stuck under your foot.

6 Causes of Morton's Neuroma

Unfortunately, we don’t truly know what causes Morton’s neuroma. What we do know, though, is that there are some things that can contribute to or worsen this nerve problem. Factors that contribute to Morton’s neuroma include:

  1. Wearing narrow shoes, which squeeze your toes.
  2. Rocking high-heels, since they put extra pressure on the ball of your foot.
  3. Inflammation, illness or trauma to your forefoot.
  4. Your body’s biomechanical issues. Having flat feet or high arches could cause trouble. Because both can create instability around the joints of your toes. And that may contribute to your nerve’s irritation.
  5. Having bunions or hammer toes. Both these conditions affect the shape and position of your toes. And that can putt more pressure on the nerves that lie between them, leading to irritation and pain
  6. Playing high-impact sports, such as basketball or running. When you repeatedly slam your feet into the ground, that places a lot of pressure on your feet. And the nerves. Which suddenly puts you back on the path to inflammation--and neuroma.  

Diagnosing Ball of Foot Pain

Often, we can diagnose your neuroma with a simple physical exam. Here's how we can usually tell. Most people who have Morton’s neuroma present with tenderness in their forefoot. In fact, sometimes, we can even feel a small mass in the ball of your foot. (It's not that pebble you've been feeling, but it's really there!)

Aslo, telling us about your symptoms will help us diagnose your neuroma. You'll probably have numbness or tingling. As we mentioned, it can also feel like you're walking on a pebble. Or, you may feel like there’s a clicking sensation between your toes.

With all those details, we can usually diagnose you on the exam table. But if we can’t immediately diagnose a neuroma from your exam, we may also order an ultra-sound. This test will find the enlarged nerve in your foot, and help confirm my diagnosis.

We've already said we'll need to rule out diabetes and neuropathy. But you may also need an X-ray to rule out other conditions or injuries.

Treating Morton’s Neuroma without Surgery 

Once we know you’ve got a neuroma, it’s time to explore your treatment options. And those will depend on how severe your symptoms may be. For many people with neuromas, we can offer pain relief by changing your shoes. If you choose flat-soled, supportive shoes instead of high heels, you'll already be in better shape. Then, when we make sure you have room for your toes and plenty of padding beneath the ball of your foot, you may no longer notice symptoms. After all, a proper shoe can take pressure off your neuroma, providing you with comfort and relief.

Now, what if different shoes alone aren’t working? Well, we can get you fitted for custom orthotic inserts with metatarsal support. These can take the pressure off the ball of your feet. And minimize your symptoms. Furthermore, you can try manually manipulating the bones and soft tissue to provide some relief. 

In some cases, you may also find relief from anti-inflammatory medications or injections of anesthetics or corticosteroids. Heck, we can even try shockwave therapy! After all, this form of treatment has proven to be very effective at treating the pain of Morton's Neuroma.

When is Surgery Recommended for Morton’s Neuroma?

Now that we’ve helped you understand this nerve problem, and the less invasive treatment options, it’s time to answer our initial question. Will you need surgery to relieve the pain of Morton’s neuroma?

For many people, the answer will—thankfully—be no. Conservative treatments are typically very effective at relieving your Morton’s neuroma pain. But if you’ve tried less invasive treatments and your pain persists, we may need to schedule you for surgery to treat Morton’s neuroma.

Still, we don't want you to panic. Houston podiatrist Dr. Andrew Schneider is well prepared to treat Morton's neuroma with surgery. The procedure is simple: we can see your enlarged nerve, and remove the offending piece. Afterward, you may experience mild numbness in the area. But pain won't be a problem anymore. Alternatively, in some cases, we may choose a procedure that releases the nerve from the surrounding tissue for extra relief. 

Have you been diagnosed with Morton's ready? I'm here and ready to consult with you to determine your best treatment option. Contact Tanglewood Foot Specialists to schedule an immediate appointment.



Dr. Andrew Schneider
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A podiatrist and foot surgeon in Houston, TX.