There are many conditions and injuries that can occur in the forefoot,  Morton’s neuromas are fairly common. A neuroma is a nerve condition which causes symptoms to be felt in the ball of the foot and often radiating out to two toes. The nerve splits at the ball of the foot and that is why two toes commonly feel a burning, tingling or pain sensation. Tight fitting footwear is a common irritation source to a Morton’s neuroma so if you have this condition ensure your shoes are wide and fit properly.

  • Condition

    Morton’s neuroma is a compression neuropathy of the common digital nerve, typically found in the webspace between the third and forth metatarsal heads.

  • Symptoms & Signs

    You may notice a burning or aching pain that radiates out to two of your toes. There also may be a numbness or tingling that occurs in the webspace of the toes or the toes themselves.

  • Treatment

    Reduction of pressure on the neuroma is the basis for Pedorthic treatment. A metatarsal pad (MT) has been shown to be effective in decompressing the effected nerve. In some cases the MT pad is best applied to a custom orthotic for increased support. Footwear width stretching and overall wider footwear is recommended.

Symptoms & Cause

A Morton’s Neuroma develops in response to irritation, pressure or injury to one of the nerves that lead to the toes. A neuroma is most often found between the 3rd and 4th toes but can also occur between the 2nd and 3rd. Symptoms such as tingling, burning or shooting pains out to the 3rd and 4th toes are common signs of a Morton’s neuroma. Tight footwear that compresses the forefoot can intensify the symptoms. Activities that cause repeated loading of the forefoot such as hiking or jogging can also aggravate the neuroma.

Pedorthic Treatment

The primary goal of conservative pedorthic treatment for a neuroma is to reduce pressure to the effected nerve. Tight or narrow footwear that compresses the bones that in turn may compress the neuroma must be avoided. If tight footwear is exacerbating or causing the symptoms, adding treatment options into the tight shoe such as MT pads or orthotics will only further tighten the toe box area of the shoe and treatment will fail.

Pedorthic treatment for a Morton’s neuroma may include:

  • Wider footwear, with a rounder toe box
  • Stretching the forefoot width of tight shoes
  • Metatarsal pad applied into a shoe insole
  • Custom foot orthotics with a metatarsal pad
  • Improving ankle ROM to decrease forefoot loading

If you are experiencing morton’s neuroma symptoms, you should consult your physician for a proper diagnosis and an appropriate treatment plan.

Your doctor may refer you to OKAPED to see a Canadian Certified Pedorthist for Pedorthic management of your foot pain. This may include orthopaedic footwear, shoe selection guidance, orthotics and/or foot related products such as a metatarsal pad. If you know your condition and want to learn about new products and treatments please give us a call.

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