The Morton’s or intermetatarsal neuroma is a pinching of the nerve, frequently between the 3rd and 4th metatarsal heads in the foot. It's because of a fibrosis around the nerve tissue, in this case it does get termed a ‘neuroma’ even though it is not actually a neuroma. It is more prevalent in females in their forties to sixties, suggesting that more restrictive shoes may be part of the cause.
The key symptoms are shooting pains into the toes that gradually gets worse, yet it is not necessarily a shooting sort of pain to begin with. Signs can vary from one person to another with some just experiencing a pins and needles of the forefoot, and many just a moderate tingling to burning type pains. Eventually there is usually an severe pain that could be present quite often. It usually is between the 3rd and 4th metatarsal heads, but sometimes be seen between any of them. Squeezing the ball of the foot from the sides may produce the symptom and often a click can be felt with the finger of the other hand while squeezing the foot. This is whats called a Mulder’s click.
The cause is thought to be an compression on the neural tissue by the adjoining metatarsal head, creating a ‘pinched nerve’; the most obvious being wearing footwear that are too tight round the ball of the foot. Additionally abnormal motion of the metatarsal heads may also be a factor, especially during athletic exercise. Being overweight is also a common finding in people that have a Morton’s neuroma.
Conservative treatment typically starts with advice on the right fitting of footwear and the use of metatarsal pads or domes. The shoes has to be wide enough to prevent the compression of the metatarsal heads and preferably have a lower heel height. If that's not really helpful, then a surgical removal of the neuroma is advised. From time to time the Mortons Neuroma is helped by injections in an attempt to dissolve the neuroma and cryosurgery can also be sometimes used.