Morton’s Neuroma

1neuromaThe nerves that supply the sensation to the lesser toes originate on the bottom of the foot. They travel between the long bones of the foot, metatarsals, and at the head of the metatarsal the nerve will divide into 2 nerves, one going to the adjacent 2 toes. In the area where the nerve is about to divide, a ligament crosses between and attached to the metatarsal heads and perpendicular to the nerve. This ligament is called the deep transverse intermetatarsal ligament. When there is an over use injury or injury to the nerve, the nerve can become swollen. This enlarged nerve then can become pinched between the metatarsal heads and compressed by the ligament crossing the nerve. This then causes pain and discomfort. Often patients that have a plantar plate tear of the toe joint are misdiagnosed as having a neuroma. A Morton’s neuroma is classically described and most often affects the nerve that supplies sensation to the 3rd and 4th toes that lies between the 3rd and 4th metatarsals. Yet, it can occur at the nerve between any of the toes.