Morton’s Neuroma

A Morton’s neuroma is a thickening of the tissue that surrounds the small sensory nerve leading to the toes. The nerve passes under a ligament which  connects the metatarsal bones in the forefoot. This can cause pressure on the nerve.

Morton’s neuroma most frequently develops between the 2nd & 3rd or the 3rd & 4th toes . Causes may include  trauma, or excessive pressure on the front of the foot, and is more common in women.

Symptoms include; the sensation of walking on a pebble, and a burning pain in the ball of the foot which may radiate into the toes. There may also be numbness or a “clicking” feeling in the toes. 

NON-OPERATIVE MANAGEMENT

Initially conservative treatment is recommended. A  combination of shoe changes, oral anti-inflammatory medications, orthotics, and/or cortisone injections will provide relief in more than 80 percent of people with Morton’s neuroma.

 Avoid high heels or tight shoes. Wear wider shoes with lower heels and a soft sole. This helps to decrease compression of the nerve. 

Custom shoe inserts and pads may help relieve irritation by lifting and separating the bones, reducing the pressure on the nerve. 

An initial Vasyli orthotic can be fitted at MOG, however a custom made orthotic by a Podiatrist may be required. 

An injection of a corticosteroid will reduce the swelling and inflammation of the nerve, which should provide relief. 

OPERATIVE MANAGEMENT

Conservative treatment may not completely relieve symptoms, or the condition may  return after a period of conservative therapy. Surgery involves  removing a small portion of the nerve  ‘neurectomy’ and releasing the transverse ligament to relieve tension on the nerve. The surgery is usually a same-day discharge procedure. Walking is allowed, with a 2 week resting period. 

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