Morton's Neuroma

  What is Morton's neuroma?

Morton's neuroma is irritation and thickening of one of the nerves in the forefoot.

It most commonly affects the nerve between the third and fourth toes.

Despite the name, it is not usually a true tumour.

What symptoms and signs might I experience?

• Burning or sharp pain in the forefoot.
• Shooting pain into the toes.
• Tingling or numbness.
• A sensation of having a stone or pebble in the  shoe.
• Symptoms worse in narrow footwear.
• Relief after removing your shoes.
• Pain when squeezing the forefoot.

How is it diagnosed?

Diagnosis is usually made through clinical examination.

An ultrasound or MRI may be used if the diagnosis is uncertain or to exclude other causes of forefoot pain.

How is it treated without surgery?

Treatment may include:

• Wide-fitting shoes.
• Low-heeled footwear.
• Metatarsal pads.
• Insoles.
• Activity modification.
• Pain relief.
• Physiotherapy in selected cases.
• Corticosteroid injection.

When might surgery be considered?

Surgery may be considered if symptoms remain troublesome despite appropriate non-operative treatment.

What might surgery involve?

There are multiple surgical approaches:

Nerve decompression: releasing structures that are putting pressure on the nerve.

Neurectomy: removing the affected section of nerve.

Following neurectomy, permanent numbness between the toes is expected.

What is recovery like?

Most patients can walk in a postoperative shoe relatively soon after surgery. Swelling and forefoot sensitivity can persist for several weeks.