Serkan: Created page with "'''Morton's disease''', more commonly known in modern medicine as '''Morton's neuroma''', is a painful condition that affects the ball of the foot, most commonly the area between the third and fourth toes.¹ It is characterized by the thickening of the tissue around one of the nerves leading to the toes, which causes sharp, burning pain in the forefoot.² The condition is named after American surgeon Thomas George Morton (1835–1903), who described..."

2025-06-22T14:11:25Z

Created page with "'''Morton's disease''', more commonly known in modern medicine as '''Morton's neuroma''', is a painful condition that affects the ball of the foot, most commonly the area between the third and fourth toes.1 It is characterized by the thickening of the tissue around one of the nerves leading to the toes, which causes sharp, burning pain in the forefoot.2 The condition is named after American surgeon Thomas George Morton (1835–1903), who described..."

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'''Morton's disease''', more commonly known in modern medicine as '''Morton's neuroma''', is a painful condition that affects the ball of the foot, most commonly the area between the third and fourth toes.1 It is characterized by the thickening of the tissue around one of the nerves leading to the toes, which causes sharp, burning pain in the forefoot.2

The condition is named after American surgeon Thomas George Morton (1835–1903), who described it in detail.3 While the historical term "Morton's disease" is still occasionally used, "Morton's neuroma" has become the preferred term, although it is not a true neuroma (a benign tumor of nerve tissue) but rather a perineural fibrosis, which is a buildup of fibrous tissue around a nerve.4

''For the condition involving the relative length of the first and second toes, see Morton's toe.''

== Pathophysiology ==
Morton's neuroma occurs as the common plantar digital nerve, which runs between the metatarsal bones in the foot, becomes compressed and irritated.5 This chronic irritation leads to the thickening of the nerve and the surrounding fibrous tissue.6 The most frequently affected nerve is the one that runs between the third and fourth metatarsal heads, as this space is anatomically narrower.

The definition provided in historical texts, which attributes the cause to a "falling metatarsal arch," points to the role of biomechanical instability. When the transverse arch of the foot collapses, it can cause the metatarsal heads to pinch the nerve that runs between them, leading to the characteristic symptoms of neuralgia (nerve pain).

== Signs and Symptoms ==
The onset of Morton's neuroma is often gradual.7 Symptoms may be intermittent at first, frequently brought on by wearing narrow or high-heeled shoes.8 Common symptoms include:

* A sensation of standing on a pebble or a fold in one's sock.9
* A sharp, burning, or shooting pain in the ball of the foot that may radiate into the adjacent toes.10
* Numbness, tingling, or cramping in the affected toes.11

The pain is typically worse during weight-bearing activities and is often relieved by taking off shoes and massaging the foot.12

== Causes and Risk Factors ==
The primary cause of Morton's neuroma is mechanical irritation and compression of the plantar digital nerve.13 Several factors can contribute to this pressure:

* '''Footwear:''' Wearing high-heeled shoes, which push the foot forward, or shoes that are tight and narrow in the toe box, are significant contributing factors.14
* '''Foot Deformities:''' Individuals with other foot problems, such as bunions, hammertoes, or flat feet, are at a higher risk of developing a neuroma.15
* '''High-Impact Activities:''' Repetitive stress on the forefoot from activities like running or racquet sports can lead to irritation.16
* '''Anatomy:''' In some individuals, there is simply less space between the metatarsal bones, making the nerve more susceptible to compression.17

== Diagnosis ==
Diagnosis is largely clinical, based on a patient's description of symptoms and a physical examination of the foot.18 A physician may perform maneuvers to elicit the symptoms, such as squeezing the metatarsal heads together (Mulder's sign), which often produces a painful click and reproduces the patient's pain.

While the neuroma itself is not visible on X-rays, imaging may be used to rule out other causes of forefoot pain, such as a stress fracture.19 Ultrasound and Magnetic Resonance Imaging (MRI) can visualize the thickened nerve tissue and are often used to confirm the diagnosis.20

== Treatment ==
Treatment strategies vary depending on the severity of the symptoms and range from conservative care to surgery.21

* '''Conservative Treatment:''' The initial approach is typically non-invasive.
** '''Footwear Modification:''' Changing to wider, more comfortable shoes with a lower heel and a roomy toe box is the most important first step.22
** '''Orthotics and Padding:''' Custom or over-the-counter shoe inserts, such as a metatarsal pad, can help lift and separate the metatarsal bones, reducing pressure on the nerve.23
** '''Activity Modification:''' Temporarily avoiding activities that put repetitive pressure on the forefoot can allow the inflammation to subside.24
* '''Injections:''' Corticosteroid injections into the affected area can help reduce swelling and inflammation of the nerve, providing significant pain relief.25
* '''Surgery:''' If conservative treatments fail to provide adequate relief, surgery may be considered.26 The most common surgical procedure is a '''neurectomy''', which involves the removal of the affected portion of the nerve.27 Another surgical option is a decompression procedure, where surrounding ligaments are cut to create more space for the nerve.28

[[Category:Medical Terms]]

Morton’s disease - Revision history