What is That Tingling, Burning Feeling in My Feet?

Morton’s Neuroma

A neuroma is a thickening of a nerve and can occur anywhere in the body, even the foot. Morton’s neuroma describes a neuroma of a specific location in the foot, between the third and fourth metatarsals. This is located on the balls of foot between the third and fourth toes. Clinicians may refer to this benign growth as a tumor. In medical terms this is a correct description but this is not an indication of cancer. The enlarged nerve is benign, meaning it will not become invasive or become cancerous.

Though a morton’s neuroma is not a medical emergency, it can cause severe pain and impede on your daily life. Some patients describe the pain as walking on a marble, but the most often complaint is a burning, sharp pain. Tingling and numbness is also common.

It is thought that the nerve becomes enlarged due to repetitive irritation or pressure. Over time, this irritation leads to a neuroma and pain. Wearing shoes that are tight, too small, or with a heel can aggravate the pain because it causes increased irritation. The pain may also be caused by running or other sports. Flexing and relaxing your toes causes compression on the nerve, and the balls of your foot takes on the most weight during walking or running. Since this is the area where the neuroma is located, doing such activities can elicit a lot of pain.

The podiatric physician will take x-rays of a patient with such pain to rule out a fracture or other foot disorders. The doctor will also attempt to elicit the pain by squeezing the foot. This will not only cause pain, but there the doctor will also hear a clicking sound due to the neuroma shifting between the bones.

There treatment ranges from conservative treatments to surgery. Like all treatment plans, surgery should be a last resort for when all other treatments fail. The pain may be greatly reduced by changing shoe gear, but this is often not enough. It is very common for your podiatric physician to prescribe a custom orthotic. Many patients find relief by not only wearing orthotics but also wearing a pad under the balls of their foot. A podiatric physician can properly fit and provide such padding. Non-steroid anti-inflammatory drugs, such as Advil, can also be used to help reduce the pain but should not be used long term. Your doctor may also suggest a steroid injection which has a greater effect on relieving the pain. Stretching, massages, and icing has also shown to relieve pain.

If the pain has increased due to physical activity, it is suggested to take some time off from the activity to allow your foot to rest and heal. It may be better to take on activities that cause less impact on the foot. Excises’ such as swimming or bicycling may be good alternatives.
Neuromas are not life threatening, but they do cause alterations in your life. You should consider wide toed shoes with plenty of room for your toes to wiggle. The pain most often subsides with conservative treatment, but in rare cases surgery is necessary. Unfortunately, the procedure removes the entire nerve and will leave numbness of the effected toes. Thus, you and your podiatric physician should try to avoid surgery if possible.