Tingly Toes – What on Earth is a Morton’s Neuroma?

Every once in a while we get a patient who complains of numbness, tingling, and/or pain in the toes, nearly always on only one foot. This point is actually quite important because it allows us to fairly safely rule out neuropathy (see our other blog on this topic).

Sometimes these symptoms will also be present in between the long bones on the same foot.

At this point we will often order an ultrasound to see if the patient has a Morton’s neuroma. This is a section of nerve that has become thickened and irritated usually due to being compressed between the long bones, in between which the nerve sits, hence the tingling, numbness and/or pain. The reason the toes are involved is that they get the referred sensations from higher up the foot.

So once you’ve been diagnosed with a Morton’s neuroma, what do we do?

A very common, non-invasive treatment involves adding a metatarsal dome to either the insole or orthotic in your shoe to help lift and separate those long bones, giving the nerve a bit more space. This can provide relief for most patients, however in some people the symptoms either do not resolve entirely or worsen over the years, leading to the next step – surgery.

But before you panic, take heart – surgery is vastly improved with modern techniques and these days it involves a simple day procedure where the surgeon goes in through a small incision in the top of the foot and removes the damaged section of nerve. “But wait!” you say, “If my nerve is removed will I lose sensation in my feet”? The answer is no….there are many collateral sensory nerves that will continue to supply the foot and the size of a Morton’s Neuroma is actually very small.

A good choice for this procedure is a Podiatric Surgeon who specializes in only the foot and ankle and has the technique down to a fine art.

Until you get to that stage, come and see your podiatrist who will do everything he or she can to stave off the need for surgery for as long as possible. The good news is, not every patient will need surgery.

By Gentry Winters