Morton's Neuroma

Morton's neuroma refers to a nerve injury in between the toes which causes pain and thickening of the nerve tissue. Compression or chronic irritation of this interdigital nerve is the main cause of Morton’s neuroma.

Morton's neuroma is more common in women than in men. The associated symptoms include:

  • Burning pain in the ball of the foot that can radiate to the toes
  • Numbness in the affected toes
  • Difficulty with walking

Wearing high-heeled or pointy-toed shoes squeezes the toe bones together and worsens these symptoms.

The diagnosis of a Morton’s neuroma is made by careful examination of your foot. Palpation of the foot between the toes may reveal a tender area, as well as a sign called a Mulder’s click. Other forefoot problems are often misdiagnosed as a Morton’s neuroma. Weightbearing x-rays of the foot are required in order to rule out other pathology, and in some cases an MRI scan may be needed.

Treatment

Early treatment is critical to relieve pain. Mild to moderate cases of Morton’s Neuroma can be managed by conservative treatment. Severe cases of neuroma may require surgery.

The conservative treatment measures include:

  • Resting your foot and application of ice packs over the inflamed area to reduce swelling.
  • Anti-inflammatory medications to help alleviate pain and inflammation.
  • Steroid injections under ultrasound guidance.
  • Simple footwear modifications include using low-heeled and broad toe box shoes with special pads to minimize discomfort between of the toes.

Surgery is considered as the last option if the symptoms fail to resolve with conservative treatments. Other factors include the age and activity level of the individual, and extent of damage to the nerve.

Surgical treatment involves release of the compressed nerve by resection of the neuroma (neurectomy) and the surrounding scar tissue. The resected soft tissue should be sent off for histopathological review to confirm the specimen as a neuroma.