Mortons Neuroma

What is Mortons Neuroma?

In this condition there is ‘shooting, electric shock like pains’ or numbness in one or two toes of the foot. It is important to know that this is not actually a tumour.

This occurs because a nerve between the toes at the bottom of the foot gets pinched. As the nerve gets pinched, the nerve gets swollen, and we call this a neuroma. By removing the nerve, the swelling of the nerve or the neuroma is removed as well.

What causes a morons neuroma?

It is unclear as to why people develop this condition. However some possible causes are:

Tight narrow shoes may aggravate the symptoms by compressing the toe bones and pinching the nerve.

Trauma may also contribute to inflammation of the nerve and entrapment.

What are the symptoms caused by this condition?

Normally there is no lump or swelling present as this is not actually a tumour.
Burning shooting type of pain radiating into the toes or the ball of the foot may occur. There may also be numbness in the toes.
Runners may feel pain on ‘push off’ and women wearing high heeled shoes may find symptoms aggravated as the heels simulate a feeling of ‘push off’.

How is this condition diagnosed?

Your consultant will examine your foot clinically and this usually makes the diagnosis clear. Specifically he will feel for a ‘palpable click’ between the toe bones to try to reproduce the symptoms of pain in the toes.
X-rays may be taken to determine whether there is any fracture or arthritis in the toe bones.

Can the condition worsen?

People function normally with this problem for years without much discomfort. However if symptoms worsen you can seek medical attention.

What treatment options are there?

Initial treatment options are non surgical and relatively simple.

Footwear modification:
Shoes a wide toe box and low heels will help the toe bones to spread out and relieve pressure on the nerve.

Injections:
A steroid injection may help reduce inflammation and ease symptoms. This may be successful in about 40% of cases.

Surgery

Surgery is the last option to be employed if non surgical treatments have failed. The most common option employed is to excise the affected part of the nerve. Please refer to Mortons Neuroma Excision for further information on the surgical procedure.

Is surgery necessary?

The decision to proceed with surgery should be taken after non surgical options described above have been exhausted. The majority of patients will benefit from shoe wear modifications. If symptoms continue to affect lifestyle and function in spite of this then surgery may be discussed with your consultant and he will advise you regarding the pros and cons of surgery.