Do you have tingling and pain in the ball of your foot? You may have a Morton's neuroma, a common swelling of a nerve in your foot which affects a range of people from tennis players to high heel lovers.
Morton's neuroma occurs when a nerve in your foot becomes thickened and scarred as a result of chronic pressure. This nerve is known as the digital nerve and runs between the metatarsals or forefoot bones. Increased pressure from these bones, as well as a ligament which runs across all of your metatarsals, can result in the nerve thickening. A kind of scar tissue develops as the covering of the nerve swells, which in turn results in pain, tingling and numbness in the ball of your foot. The pain is usually centred between your third and fourth metatarsals and gets worse after a period on your feet. Sometimes people feel as if they're walking on a rock, especially after having been on their feet for a long period of time.
While Morton's neuroma can occur due to a person's unique anatomy, the types of movements they do frequently and the shoes they wear often play a large part. For example, high heels put pressure on your forefoot bones in a way that puts you at a higher risk of developing a Morton's neuroma. Golfers, tennis players and runners also frequently develop them due to the movements made while running or rotating the foot in question, such as during a golf swing. Women are most at risk, especially in their forties to fifties.
A Morton's neuroma will not heal on its own. It's important to see your doctor and podiatrist as soon as you have symptoms, as early treatment can stop the condition from progressing. It is usually managed well with conservative treatment including physiotherapy, medication and orthotic inserts.
Orthotic inserts are designed to provide specific support to different areas of your foot. They lie inside your footwear, helping to hold your bones in an ideal position for your condition. An orthotic insert for Morton's neuroma will help by gently lifting and splaying your metatarsals. By providing this support to your forefoot, an orthotic insert will reduce pressure on the swelling of the nerve. As your metatarsals will no longer be pressing on the neuroma as much, the pain and tingling that you feel will improve. Your podiatrist will be able to advise exactly which orthotic inserts are ideal for your foot to help alleviate the symptoms of Morton's neuroma.
In addition to an orthotic insert, your podiatrist may advise changing your footwear to prevent further pressure on your digital nerve. Shoes which provide good support to the arch and forefoot without being too tight over the top of the metatarsals are generally best.
Rarely, conservative treatment does not alleviate symptoms for Morton's neuroma. In this case, your doctor may recommend you see a surgeon to discuss if surgical treatment can improve your situation; however, this is uncommon. Most patients will be able to reduce their symptoms and return to normal activity with a mix of medication and orthotic inserts.