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What are the signs to look out for when diagnosing a Mortons Neuroma

A Mortons neuroma is a nerve entrapment syndrome of the foot. It occurs when prolonged irritation of the nerve causes thickening and sometimes scarring. It most commonly occurs between the 2-3 or 3-4 metatarsal spaces (see right).

Foot neuromas are commonly misdiagnosed for other musculoskeletal conditions such as bursitis, arthritis, sesamoiditis and tarsal tunnel syndrome. For effective treatment, the clinician must ensure a correct diagnosis. Current research suggests that Mortons neuroma can be diagnosed by thorough history-taking and clinical examination in 90-95% of cases. This means without requiring a diagnostic ultrasound or MRI.

The most common symptoms experienced by an individual with a foot neuroma is pain in the ball of the foot, which can radiate down to the toes. It may be accompanied by pins and needles, tingling, or numbness. These are classic nerve pain signs.

However this discomfort is not always easy to pin-point. Sometimes the pain may be more generalised to the front of the foot and difficult to locate. It may give the feeling of stepping on a marble or a severe crushing.

Symptoms of Mortons neuroma are often exacerbated by lifestyle factors. In particular the use of tight, restrictive or high-heeled shoes has been known to aggravate the condition. Certain activities involving jumping or landing on the front of the foot may also trigger a flare-up of symptoms.

  1. Symeonidis, P. D., Iselin, L. D., Simmons, N., Fowler, S., Dracopoulos, G., & Stavrou, P. (2012). Prevalence of interdigital nerve enlargements in an asymptomatic population. Foot & ankle international, 33(7), 543-547.
Laura RabjohnsWhat are the signs to look out for when diagnosing a Mortons Neuroma