Morton’s Neuroma - A Real Pain in the Foot

by Marcel Cadieux, C.Ped

Morton's Neuroma is a common foot problem.  Sometimes it is described as a sensation of “walking on something”, such as a bunched up sock, or a “snapping or electrical shock” sensation at the ball-of-the-foot. Symptoms of this condition can range from sharp burning pain, like a hot marble between the toes, to tingling or cramping at the forefoot, all the way to numbness or even a lack of feeling at the ball-of-the-foot between the third and fourth toes. Dr. Morton, a Viennese physician, first described this condition in 1876.

There are two general reasons for the onset of Morton's Neuroma.  The first is related to the unique anatomy of this area of the foot. Secondly, flat and flexible feet are more prone to the development of a Morton’s neuroma. It is not uncommon to find Morton's Neuroma in conjunction with other foot problems such as bunions and hammer toes.

Problems often develop in this area because of its unique anatomy. We need to get a little technical for a moment. The lateral plantar nerve combines with part of the medial plantar nerve here. When the two nerves combine, they are typically larger in diameter than those going to the other toes. These two nerves are forced to share the space between the third and fourth toes. Below the nerve is the foot’s fat pad. Above the nerve is a structure called the deep transverse metatarsal ligament. This ligament is very strong and holds the metatarsal bones or toe bones together and creates the ceiling for the nerve compartment. With each step, the foot’s fat pad pushes up on the enlarged nerve and the deep transverse metatarsal ligament pushes down. This causes compression in a confined space. Morton's Neuroma can be considered to be similar to other nerve entrapments such as carpal tunnel syndrome. The pain is usually less severe when the foot is not bearing weight.