What is Morton's neuroma?

It involves an irritation or compression of a small nerve in the foot, located between two bones called metatarsals. This nerve irritation can lead to inflammation, causing pain. The nerve most commonly affected is between the 3rd and 4th metatarsals.

‍

What is a nerve?

Nerves are responsible for transmitting information to our nervous system. This information travels through the nerve in the form of electrical signals. For example, nerves allow us to feel our skin when we touch a part of our body. They also send electrical signals to our muscles, causing them to contract and move our limbs.

‍

What are the causes of Morton's neuroma?

It can be caused by:

• Trauma or impact directly on the nerve (dropping an object on the foot, bumping the foot)
• Repetitive small traumas to the foot leading to overload on the nerve (incorrect dosage of running or walking)
• Overload on the forefoot (wearing high heels more than usual)
• Switching to shoes that are too narrow or tight

‍

What are the symptoms of Morton's neuroma?

The most common symptoms are:

• Pain under the foot at the base of the toes. The pain can be described as:

• A burning sensation
• Electric shocks
• A feeling of swelling
• A sensation of having a thicker foot or a lump under the foot, as if walking on a fold in a sock

• There may be numbness, tingling, or pins and needles in the foot or toes
• The pain is worse when wearing shoes or high heels (especially if the shoes are narrow)
• The pain is reduced when shoes are removed
• The pain is increased by walking, prolonged standing, and running

‍

How is Morton's neuroma diagnosed?

Diagnosis is possible through a review of the history of symptoms and a clinical examination.

‍

When should I see a physiotherapist for Morton's neuroma?

You should consult a physiotherapist if you have symptoms as described above or if your doctor has already ruled out any other cause that may be responsible for your pain.

‍

You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.

‍

What are the physiotherapy treatments for Morton's neuroma?

Your physiotherapist will perform an evaluation to determine the cause of your patellofemoral syndrome and will assess the following elements:

• Your joint mobility
• The gliding of your nerves
• The quality of your movements
• Your strength and stability

‍

Based on the assessment results, your physiotherapist will:

• Mobilize your nerve with specific treatment techniques for nerves
• Provide you with specific exercises to retrain the strength and stability of your foot.
• Provide you with specific exercises to learn how to properly control your movements and desensitize your nerve.
• Teach you how to properly manage your daily activities and hobbies to optimize healing
• Give you advice for your posture and movements.

‍

What can I do at home for Morton's neuroma?

Temporarily reduce the amount of time you spend doing activities that cause too much pain, and then gradually resume them.

‍

Here are some tips that may help:

• Engage in activities that reduce stress on the area, such as swimming.
• Take frequent but short breaks in a seated position if the pain increases when you walk or stand for long periods.
• Wear wider shoes with thicker soles temporarily, or even sandals without straps if needed.

‍

If you don't see any improvement after 10 days, you should consult a physiotherapist.

‍

If you are a runner, refer to the blog post on running (link to come) for specific running tips.

‍

‍

To learn more...

You can listen to the podcast PARLE-MOI DE SANTÉ created by one of our physiotherapists, Alexis Gougeon.

‍

Episode #1 discusses the prevention and treatment of running injuries.

‍

Find the episode on YouTube:

Click below to listen to episodes on podcast platforms:

‍

‍

‍

Sources

• Munir U, Morgan S. Morton neuroma. InStatPearls [Internet] 2019 Feb 28. StatPearls Publishing.
• Thomas JL, Blitch EL, Chaney DM, Dinucci KA, Eickmeier K, Rubin LG, Stapp MD, Vanore JV. Diagnosis and treatment of forefoot disorders. Section 3. Morton’s intermetatarsal neuroma. The Journal of foot and ankle surgery. 2009 Mar 1;48(2):251-6.

‍

‍