Each week a few patients will present with the complaint of a burning, “hot rock”, pain in the ball of their foot. Typically the pain is worse in shoes and when walking. Now there are several possibilities as far as diagnosis, but one of the most common is Morton’s neuroma.
Morton’s neuroma is a thickening of tissues around the nerve that leads to the toes. Morton’s neuroma usually develops between the third and fourth toes in response to irritation, such as that caused by wearing high-heeled or narrow shoes, or from trauma. Symptoms may include a burning pain that radiates from the ball of the foot to the toes or numbness in the toes. Conservative treatments usually resolve the pain or progressions of the condition, and range from wearing roomier, lower-heeled footwear or using orthotics to reduce the pressure on the nerve, to injections of cortosteroid medication to reduce swelling and inflammation. Occassionally a series of injections are used to destroy the nerve or surgical excision of the nerve is necessary. Fortunately, neuromas respond well to conservative care.