Morton's Toe and Morton's Neuroma Are Not Related
Morton's toe (a longer second toe) and Morton's neuroma (nerve thickening in the foot) are completely separate conditions with no established relationship. They share only the eponymous name "Morton" but represent distinct anatomical and pathological entities.
Key Distinctions
Morton's Toe
- An anatomical variant where the second metatarsal bone is longer than the first, making the second toe appear longer 1
- This is a normal structural variation, not a pathology
- Named after Dr. Dudley Morton who described this foot structure
Morton's Neuroma
- A mechanically-induced degenerative neuropathy causing fibrosis (not a true neuroma) of the common digital nerve, most commonly affecting the third web space 2, 3
- Occurs predominantly in middle-aged women who wear tight, high-heeled shoes 1, 2
- Results from entrapment or repeated microtrauma to the nerve 1
- Named after Dr. Thomas Morton who described this nerve condition
Clinical Presentation Differences
Morton's neuroma presents with:
- Paroxysmal forefoot pain in the web space between toes, typically the third 1, 4
- Pain triggered by tight footwear, particularly high heels 1
- Positive Mulder's test on physical examination 1
- Diagnosis confirmed by ultrasound (90% sensitivity) or MRI (93% sensitivity) 5, 6
Common Pitfall to Avoid
The shared surname "Morton" creates confusion, but these are unrelated conditions. Morton's toe is simply a foot shape variant, while Morton's neuroma is a painful nerve pathology requiring treatment with shoe modifications, corticosteroid injections beside (not into) the neuroma, or surgical excision if conservative measures fail after 4.5 months 7, 8.