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Foot Health: Feel like you are walking on a pebble? You just might have a Morton’s Neuroma

By Dr. Matthew Ellsworth
Special to KyForward

Morton’s neuromas are small yet painful lumps that develop on the ball of the foot, typically between the third and fourth toes. Not only can these small lumps cause you to feel as though you are standing on a pebble, but they can cause burning, numbness or tingling to your toes.

If you have foot pain, especially in the ball of your foot between the third and fourth toe, you may be suffering from Morton’s neuroma. Wearing high heels or tight shoes increases the risk for developing this condition. Likewise, partaking in high impact activities, such as running, may also cause Morton’s neuroma–by subjecting your feet to frequent trauma. Lastly, if you suffer from bunions, hammertoes, or flatfeet, you have a higher chance of developing a neuroma.

While the exact cause of Morton’s neuromas is unknown, it is associated with nerve irritation related to narrow shoes and foot injury. Narrow shoes irritate the nerve which is confined in a small web space between the toes. As a result, a neuroma (thick nerve tissue growth) develops as a natural reaction to the injury.

If you have foot pain, especially in the ball of your foot between the third and fourth toe, you may be suffering from Morton's neuroma (Photo Provided)

If you have foot pain, especially in the ball of your foot between the third and fourth toe, you may be suffering from Morton’s neuroma (Photo Provided)

In addition to tight shoes, foot disorders such as poor arches, hammertoes, and bunions are known to be main causes of Morton’s Neuroma. Athletes are also more likely to develop this condition due to their constant exposure to high impact physical activity.

The following risk factors may increase the chances of getting a neuroma:

• Your Choice of Footwear: Both high heels and shoes that are too tight may increase your chances of developing a neuroma. Choose shoes with a wider toe box.

• Physical Activities: While staying active is a great way to stay in shape and maintain a healthy weight, if you choose the wrong sport, you may be setting yourself up for trouble. Certain high impact sports, such as running and jogging may cause enough repetitive foot trauma to lead to a neuroma.

• Foot Deformities: Do you have high arches, flat feet, bunions or hammertoes? If so, something as simple as standing and walking can put extra pressure on the ball of your foot, leading to a Morton’s neuroma.

Treatment for Morton’s Neuromas

The first defense to treat Morton’s Neuroma is to reduce the inflammation and the nerve injury. The best way to accomplish this is to choose a pair of shoes with stiffer soles and combine with orthotics to take the pressure off the ball of the foot. The orthotics can be adjusted with felt or foam padding as needed to decrease the pressure.

Icing and resting the foot can also be effective treatments to relieve the pressure. Careful and routine use of Ibuprofen or other NSAIDS can be a helpful treatment.

Steroid and/or alcohol sclerosing injections may be helpful in treating the disease. These injections decrease the inflammation around the nerve tissues to allow softening of other surrounding tissues.


If all of the above treatments fail, then surgical removal may be necessary. However, with surgery there is a possibility that, after a few years, the nerve could grow back or develop into a “stump neuroma.” In such a case, the surgery would have to be repeated. This can be prevented by safely tracing the nerve deeply into the foot as practically possible.
With neuromas, as with most other things, an ounce of prevention is worth a pound of cure.


Dr. Matthew Ellsworth, AACFAOM, is an associate at Lexington Podiatry

For more Foot Health columns, click here.

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