Morton's neuroma
Understanding this condition
Morton's neuroma is a chronic irritation of a small nerve located between two metatarsal heads, most often between the 3rd and 4th (or between the 2nd and 3rd). Through repeated compression between the bones, the nerve thickens and becomes inflamed.
Predisposing factors include narrow footwear, high heels, prolonged walking, and foot morphology. The condition predominantly affects women.
Symptoms
The characteristic sign is a burning, "electric-shock" pain between two toes, triggered by walking in closed shoes and relieved by removing shoes and massaging the foot.
The sensation of "walking on a pebble" or on a bunched-up sock is typical. Numbness or tingling may be felt in the affected toes.
How can it progress?
The course is variable: some neuromas remain stable for years, while others become disabling. Pain may restrict walking and shoe-fitting.
Without management, pain tends to increase in frequency and intensity.
Treatment options
First line: wide shoes, orthopaedic insoles with a metatarsal bar, cortisone injections (often effective, sometimes sufficient).
In cases of medical treatment failure, surgery can be offered to release or remove the compressed nerve. The procedure is brief and allows rapid return to walking. A consultation establishes the indication.