Patient information leaflet
What is Morton’s neuroma?
Morton’s neuroma is a common condition that causes pain in the ball of the foot and sometimes the toes. Although we are not certain as to the cause of this condition we think it is likely that one of the small nerves to your toes is being trapped between the bones giving rise to the type of symptoms you have been suffering from.
What are the symptoms of Morton’s neuroma?
Usually patients suffer from some of the following list of symptoms:
; Pain in the ball of the foot
; Pain in the middle toes
; Numbness or “dead” feeling in toes
; The pain is not constant but intermittent
; Pain is worse on walking
; Pain is often worse with a particular pair of shoes
; Sometimes patients gain relief by removing shoe and rubbing the
; The pain can be present for a many months or years
What investigations are required?
A diagnosis is used made on examination of your foot. X-rays do not show a neuroma. Ultrasound scans of your foot can be helpful to identify the precise site of the swelling and also the size of the swelling. This can be helpful in deciding what to do in the way of treatment.
What treatment is possible for this condition?
There are 4 main approaches to treatment for this condition.
The first approach is to consider footwear. Ensure that your shoes are roomy with enough room for the forefoot and toes. Preferably, wear a shoe that is a lace-up and avoid court shoes and especially avoid high heels. You may find that training type shoes are most comfortable.
Often special insoles worn inside your shoe can help. We can arrange for you to be seen by the orthotist here at the RIE for the supply of insoles.
3. Steroid injections
Sometimes a small amount of local anaesthetic (similar to that used by your dentist) and steroid are injected between the bones of your foot. However we are not sure how successful this injection is and some patients experience adverse reactions from the steroid injection of which a painful foot for a day or two is the most common.
Finally, if still troubled with this condition, some patients require a small operation to remove the painful nerve. This is usually successful in alleviating the pain of this condition in about 75 – 80% of patients.
What does the operation involve?
The operation involves removal of the nerve. This is done through an incision on the top of your foot. You are able to weight bear afterwards but you are better to stay off your feet as much as possible for about two weeks. It can be several months before full benefit from the operation. It is possible that a new neuroma may develop afterwards which may require a further operation.