Morton’s neuroma is a painful condition that affects a nerve in the foot, most commonly between the third and fourth toes. It happens when the nerve becomes thickened or irritated, usually due to repeated pressure or trauma. This thickening causes inflammation and can lead to sharp, burning pain, numbness, or a sensation like stepping on a pebble in the ball of the foot. The nerve irritation is often worsened by tight or ill-fitting shoes, especially those with narrow toe boxes or high heels that squeeze the forefoot.
In older adults, Morton’s neuroma can be particularly troublesome because their feet often undergo changes that make them more vulnerable. As people age, the natural padding under the foot thins, reducing cushioning and increasing pressure on the nerves. Additionally, older adults may have foot deformities such as bunions or hammertoes, which alter the foot’s shape and mechanics, further compressing the nerves between the metatarsal bones. These deformities can shift weight distribution, causing more irritation to the nerve and worsening symptoms.
Another factor in older adults is the decline in circulation and nerve health. Aging can reduce blood flow to the feet, which slows healing and makes tissues more fragile. Poor circulation can also cause numbness or coldness, masking early signs of nerve problems and delaying diagnosis. Muscle weakness and reduced balance in the lower legs and feet, common with aging, may also contribute indirectly by changing gait and increasing stress on certain parts of the foot.
The symptoms of Morton’s neuroma in older adults often include burning pain in the ball of the foot, tingling or numbness in the toes, and discomfort that worsens with walking or wearing tight shoes. The pain may feel like an electric shock or a sharp stabbing sensation. Because these symptoms can mimic other foot problems common in older people, such as arthritis or diabetic neuropathy, it is important to get a professional evaluation to confirm the diagnosis.
Treatment for Morton’s neuroma in older adults usually starts with conservative measures. These include wearing wider, more supportive shoes with cushioned soles to reduce pressure on the nerve. Orthotic inserts can help correct foot mechanics and redistribute weight away from the affected nerve. Avoiding high heels and tight footwear is crucial. Physical therapy may improve foot strength and flexibility, which can relieve symptoms.
If conservative treatments fail, other options include corticosteroid injections to reduce inflammation or minimally invasive procedures to relieve nerve compression. In rare cases, surgery may be necessary to remove the thickened nerve tissue. However, surgery in older adults carries higher risks and requires careful consideration.
Because older adults often have multiple foot issues and slower healing, managing Morton’s neuroma requires a comprehensive approach that addresses footwear, foot structure, circulation, and overall health. Regular foot exams are important to catch problems early and prevent worsening pain or complications. With proper care, many older adults can find relief from Morton’s neuroma and maintain mobility and quality of life.
