Easing pain of Morton’s neuroma

DEAR DOCTOR K: I have something called Morton’s neuroma. Can you explain what it is, and what I can do to relieve the pain?

DEAR READER: A neuroma develops when a nerve is compressed, injured or pinched, causing swelling and pain. A neuroma in the area between the third and fourth toes, or between the second and third toes, is known as a Morton’s neuroma.

Morton’s neuroma causes sharp, burning pain and numbness in the toes and foot. You may feel like you’ve stepped on a tiny hot coal and can’t get rid of it. At the same time, you’ll have the disconcerting experience of not being able to feel your toes. Sometimes the nerve tissue becomes so thickened you can feel or see a lump.

Women, particularly those who wear tight shoes, are at greatest risk for Morton’s neuroma. The best way to prevent the condition is to wear shoes with wide toe boxes. Tight, pointed shoes squeeze bones, ligaments, muscles and nerves. High heels may worsen the problem by shifting your weight forward. Over time, this combination can cause the nerves to swell and become painful.

Wearing shoes that provide enough room in the toe box is also the first step in treating Morton’s neuroma. For instant relief when pain flares up, try taking your shoes off and rubbing the area. The nerve can get trapped below the ligament, and rubbing can move it back to its natural position.

Your doctor or a foot-care specialist may recommend lower heels and metatarsal pads. These pads provide cushioning under your neuroma and better arch support to redistribute your weight. If you keep pressure off the toes and wear wide enough shoes, the problem may gradually disappear.

For severe or persistent pain, you may need surgery to remove the neuroma. Once the nerve is gone, you permanently lose feeling in the affected area.

One alternative to surgery is to undergo neurolysis injections. These use chemical agents to block pain signals. Another alternative is to take a prescription pain reliever that alleviates nerve pain.