Merck Manual

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Damage to Nerves in the Foot

(Interdigital Nerve Pain; Interdigital Neuralgia; Morton Neuroma; Morton Neuralgia)

By

James C. Connors

, DPM, Kent State University College of Podiatric Medicine

Reviewed/Revised Dec 2023
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Irritation of interdigital nerves (in the balls of the feet) may cause enlargement of those nerves, causing pain in the balls of the feet.

  • Typical symptoms include a mild ache around the third or fourth toe that progresses to a burning or tingling sensation.

  • The diagnosis is based on the person’s history and an examination of the foot.

  • Modification of footwear, pads, and sometimes injection of a corticosteroid can help relieve symptoms.

Causes of Damage to Nerves in the Foot

The nerves that supply the bottom of the foot and toes (interdigital nerves) travel between the bones of the toes. Pain in the ball of the foot may be caused by longstanding irritation of the nerves. The irritation often causes the nerves to enlarge and noncancerous (benign) thickening of the tissue surrounding the nerve (neuromas) to form, usually between the base of the third and fourth toes (Morton neuroma). However, these irritated nerves may occur between any of the toes. Neuromas usually develop in only one foot and are more common among women.

Many factors contribute to nerve irritation, particularly nonsupportive or tight fitting shoes. Other factors include thinning of the fat at the ball of the foot, poor foot posture, or abnormal foot structure that stretches the nerves.

Symptoms of Damage to Nerves in the Foot

In the early stages, a neuroma may cause only a mild ache around the third or fourth toe, occasionally accompanied by a burning or tingling sensation in the toes, particularly as the disorder progresses. These symptoms are generally more pronounced when a person wears certain types of shoes, especially those that are too narrow for the front part of the foot, including those that are pointed. As the condition progresses, a constant burning sensation may radiate to the tips of the toes, regardless of what shoes are worn. In time, most people are unable to wear most closed-toe shoes. A person may also feel as if a marble or pebble is inside the ball of the foot.

Diagnosis of Damage to Nerves in the Foot

Treatment of Damage to Nerves in the Foot

  • Footwear changes

  • Injections

Injecting the tender spot in the foot with a corticosteroid/anesthetic mixture and wearing proper shoes and sometimes orthoses (devices placed in the shoe) may relieve the symptoms. Rest and applying ice may also be recommended.

Sometimes cryotherapy (application of cold) or injection of alcohol into the neuroma may also relieve pain. If these treatments do not help, surgical removal of the neuroma often relieves the discomfort completely but may cause permanent numbness in the area.

NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
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