Morton's Toe: Symptoms and Treatments




The condition commonly known as a Morton's toe is also called Morton's syndrome and long toe. The last of these names is the most descriptive and perfectly captures the nature of the condition itself. First discovered in the 1920s by Dr. Dudley J. Morton, the condition was later understood to be a primary cause of pain and discomfort throughout the body. Dr. Janet Travell, who worked in the White House in the Kennedy administration discovered these effects.

Note, Morton's Toe is not to be confused with Morton's Neuroma which is is a tumor-like growth in your toe join.

What is Morton's Toe?

morton's toeIn a Morton's toe, a patient has a short first metatarsal, as compared to the second metatarsal. The first metatarsal refers to a bone in the foot; it is the finger-like bone which the big toe connects to. This bone is quite large; it extends from the base of the toe about halfway to the heel. Each toe has a metatarsal, meaning that each foot has five such bones. The "first metatarsal" attaches to the big toe; the "second metatarsal" attaches to the second toe (the one right next to the big toe).

In the condition known as a Morton's toe (or Long Toe), therefore, the first metatarsal is shorter than the one next to it. This causes the second toe to appear longer than the big toe. In some cases it appears to be much longer and the patient's foot looks as though it has a true deformity.

Symptoms Indicating a Morton's Toe

To determine if your first metatarsal bone is short, take off your socks and take a good look at your feet. If your second toe is longer than your big toe, you might have a shortened first metatarsal – but you might not, since other factors can be involved in the outward appearance of the feet.

picture of morton's toeKeep in mind that most occurrences of a Morton's toe are not extreme. Even a slightly shorter big toe as compared to the second toe can be an indicator for the condition. In extreme cases, however, the difference in toe length is impossible to miss.

A second method for evaluating whether your first metatarsal bone might be shorter than usual is to try to see where your first and second metatarsal bones attach your toes to the rest of your foot. You can detect this location by holding down your toes and finding "bumps" where the metatarsal bones end. (Technically these bumps are the heads of the bones.) 

Mark the location of the bumps with a felt tip pen, being sure to draw a line where the bumps end, not begin. This should give you the location of the ends of the heads of the bones. Now compare the location of the lines. If the line for the second toe is closer to your leg than the line for your big toe, it's likely that your first metatarsal bone is shortened.

Another possible sign of a short first metatarsal bone is excess skin between the toes; this excess skin can take the appearance of webbing. This is not a sign that all Morton's toe sufferers have, but if you do have webbing here, there is a good likelihood that your first metatarsal bone is shortened and you have Morton's toe.

Diagnosis of a Morton's Toe

In most cases, a health care professional can diagnose a Morton's toe simply by a physical examination of the foot. X-rays and other tests which demonstrate the interior structure of the foot are not usually necessary.

However, your health care professional may want to conduct some additional tests in order to gather more information about the internal structure of your foot. This additional information may become useful during the treatment phase in order to accurately construct custom orthotics or other solutions that will help you manage the condition in the future.

Causes of a Morton's Toe

Morton's toe is caused by genetic factors. People are sometimes born with a shortened first metatarsal. Rather than focus on the cause of the condition, those with this foot abnormality should be more concerned with the problems that the condition itself can cause.

Sometimes patients are reluctant to believe that the basic cause of their Morton's toe is simple inheritance. They would prefer to believe that it is caused by eating a specific food, because of course that behavior can be altered. There is nothing that any of us can do to change our genetic inheritance.

One "proof" some people raise from time to time that their problem couldn't be genetic in origin is the fact that they've had the same toes and bones all their life, and yet it wasn't until recently that they began noticing any health issues associated with said toes. This is probably true, but the simple fact of the matter is that most foot problems only begin to emerge in middle age. Before that time, the body is young and spry enough that a shortened first metatarsal bone doesn't cause much damage. As we age and our ability to heal and rebound begins to decline, however, inherited traits begin to take a greater toll and trauma that has been accumulating for years will begin to make itself felt and known.

Morton's Toe Complications

Morton's Toe can cause other problems, depending on the severity of the problem and the genetics of the person suffering the condition. Here's a breakdown of some of the potential problems Morton's Toe can lead to, if untreated.

What Ailments Does a Morton's toe Lead To?

Morton's toe can cause aches and pains not only in your toe and foot area, but also across your entire body.

What Foot Ailments can be Caused by a Morton's toe?

When it comes to foot problems, the most common one caused by a Morton's toe condition results from uneven pressure in the metatarsal bones. Since the first metatarsal bone is abnormally short in a patient with Morton's toe, more pressure than usual is brought to bear on the head of the second metatarsal bone. Over time, this leads to pain and discomfort, among other negative outcomes.

Sometimes the condition is diagnosed as metatarsalgia. Over time the excessive pressure leads to other problems as well, including the formation of a callus under the second metatarsal head as the foot tries to defend itself from the pressure.

In addition to calluses, several other foot problems can result from a Morton's toe condition. These variously include:

  • bunions
  • fallen arches
  • corns
  • weak ankles and ankle pain
  • arch pain
  • hammer toes
  • neuromas
  • burning feet, primarily on the balls or in the toe area
  • heel pain
  • feet that feel tired all over
  • plantar fasciitis
  • shooting pains in the toes

What Other Ailments can be Caused by a Morton's Toe?

It may sound counter intuitive, but a problem in the foot area, particularly a serious problem such as a Morton's toe, can lead to systemic problems far from the foot. This is because our feet are fundamental to so much else we do. The way we walk affects the muscular and skeletal system of the entire body, either supporting it well and keeping muscles and bones in alignment, or warping the intended alignment and causing serious problems far from the foot itself.

When it comes to Morton's toe, problems can result in areas such as the thighs, knees, legs, hips and even backs. Sometimes patients begin to experience fewer muscle cramps as well – this leads to a situation in which they are able to sleep better and / or sleep without the aid of pharmaceuticals. Sleeping better or using fewer drugs to do so in turn has implications for general health.

It is therefore true that the awkward gait caused by a Morton's toe along with the chronic pain it can cause are in turn the causes of many other health conditions. The following list is meant to be representative rather than all-inclusive:

  • back pain
  • hip pain
  • knee pain
  • arthritis
  • fibromyalgia
  • calf pain
  • night cramps

In many instances, people with one or more of the above conditions have struggled for years to make it improve, all to no avail because the basic underlying cause was Morton's toe. Without treating this underlying cause, treating the symptoms may not be very effective.

Morton's Toe Treatments

Although in extreme cases it is possible to treat a Morton's toe using surgical procedures, in actual fact this is very rarely necessary. Most cases of Morton's toe can be managed adequately by getting the patient to wear the correct footwear.

Correct footwear for a Morton's toe condition consists of shoes that have very wide toe areas, also called "wide toe boxes." These shoes allow the toes enough room to move around even when the first metatarsal is shortened and the second metatarsal head is being subjected to excessive pressure.

Sometimes it may be difficult to find a shoe with a wider toe box in particular. In these cases, patients are advised to simply purchase shoes that are one size or one half size larger than the shoes they normally wear. These shoes will naturally be longer, which will help accommodate the extra length associated with the second toe in people with a Morton's toe condition.

It may be the case, however, that even after switching to more comfortable footwear, the patient continues to experience significant levels of pain in the foot and other areas of the body. The first thing to do in this case is make sure the footwear has been given adequate chance, but if pain still persists, patients should be sure to consult a podiatrist or foot specialist about their difficulties. Such health care professionals can advise you about orthotics, by which is meant shoe inserts designed to help shape the interior of a shoe so that it is more comfortable and appropriate for patients with various foot deformities or conditions.

Some of the features that allow orthotics to help a Morton's toe condition include:

  • arch supports – these serve to help keep the feet correctly aligned in relation to the rest of the body
  • metatarsal pads – these help to distribute stress differently so that when you walk, run, or stand there is less stress placed on the second metatarsal head and the ball of the foot

Custom orthotics are the best option in cases of Morton's toe because every person's individual foot is different. Having the orthotics sized and shaped specifically for your foot is invaluable. However, it can also be expensive; make sure that your health insurance policy will cover consultations with a podiatrist and the expense of the fittings and the orthotics themselves.

A Cure for a Morton's Toe?

Unfortunately, there exists at present no real cure for the condition of a Morton's toe. The best that patients can expect is to learn how to manage the condition so that walking, running, and jumping become easier and pain levels are reduced or eliminated. Managing a Morton's toe condition well is important for general health and for the prevention of many other conditions that can result from a toe abnormality.

While it isn't possible to cure a Morton's toe, most patients experience a great increase in their quality of life once treatment is underway. The use of proper footwear, combined if necessary with the addition of custom orthotics to the inside of shoes will make the ordinary activities of life much easier to accomplishment, and as related conditions begin to subside and go away, patients will generally be in much better health than previously.

Cautionary Notes

It is best to use only a fully licensed podiatric physician when dealing with problems of the toes or feet. These health care professionals are trained to accurately diagnose and treat a Morton's toe. They are also qualified to look critically at any treatments that may not be working as planned and adjust them as needed as time goes by.

Since a Morton's toe is a condition that can affect the entire body, it is important to treat it with the care it deserves. No patient wants to end up with neurological, circulatory, or muscular skeletal problems as a result of an untreated or poorly treated Morton's toe condition.

Although a Morton's toe itself cannot truly be cured, the conditions it can cause can in some cases be completely eliminated. It is imperative, therefore, that patients seek professional help.


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