What you should know about Mortons Neuroma

What is a Morton's neuroma?

A Morton's neuroma is one of the common sources of pain in the ball of the forefoot, known as Metatarsalgia. A neuroma occurs when the normal healthy nerves between the metatarsal heads form excess scar tissue around the nerve. This scar tissue causes pinching and squeezing between the metatarsal heads, resulting in pain.

The most common sites are centrally in the forefoot, between toes 2 and 3 or between toes 3 and 4.

Typically, there is no outward sign of this condition. People often complain of a sensation as if they are walking with a pebble or balled-up sock under their foot. They may also have a burning pain that radiates into their toes, and some experience a tingling or numbness in the toes.

What are the risk factors?

Wearing poorly fitting shoes can place extra pressure onto your toes. High heels are also guilty of exerting an increased downward pressure onto the balls of the feet.

Some high impact sports such as jogging or running can cause repetitive trauma. Also, sports where you have to wear tight fitting shoes, e.g., snow ski-ing and rock climbing increase the risk.

People who have other foot problems, such as bunions, hammertoes or arch issues, are more susceptible to neuromas.

Diagnosis is achieved by taking the patient's history and examination. During your exam the doctor will press on your foot to feel for a palpable mass or tender spot. There may also be a feeling of "clicking" between the bones. Confirmation may be done using advanced imaging such as MRI.

Treatments for Morton's neuroma

Non-surgical option

Non-surgical, conservative treatment will always be tried first. Initially you may be advised to rest the foot, thus taking the pressure off. Alongside that could be the taking of anti-inflammatory medicines. In some cases, by doing these actions you could find that the problem resolves itself. Then it is wise to look at what has triggered the problem initially and make some changes.

There are certain pads and inserts that can be trialed that aim to offload the painful site on your foot. A good supportive shoe is especially useful in conjunction with inserts.

Another option may be to have a local injection of cortisone. This is a powerful anti-inflammatory medication that may give effective relief.

Surgical option

Surgical options are available if the conservative treatment fails to give adequate relief. The most common operation is called a Neurectomy. This operation is usually done under a general anaesthetic, with an aim to be home the same day. A small incision is made on the top of the foot, at the base of the affected toes. The surgeon will then remove the part of the nerve that is causing the problem. This is effective at allevaiting the pain, but does result in some permanent numbness that is usually asymptomatic.

This procedure is done outpatient, and usually takes about 30 minutes. Patients will be asked to wear a support shoe/boot for several weeks. This takes the weight off thus allowing healing to take place. It may be between 3-6 weeks before normal shoes can be worn.

Learn more about our foot doctors at Pinnacle Orthopaedics

If you are suffering with this condition, you will know how debilitating it can be. A morton's neuroma may be small but it can cause big problems.

So why not look into getting this treated? Stop suffering, or putting up with it.

In Georgia, Atlanta there is a group of orthopedic surgeons. Within that team are specialised foot doctors with many years of experience. At Pinnacle Orthopaedics we have a Fellowship Trained Foot and Ankle specialist. Our focus goes from acute injuries to chronic ongoing problems.

Our specialists are available at five convenient locations:

If you want expert advice and treatment, we are the team to contact.

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.