Neuroma

What is Morton’s Neuroma?

Morton’s neuroma refers to a nerve injury that occurs between the toes, usually the third and fourth toes. This causes pain and thickening of the nerve tissue.

What are the Causes of Morton’s Neuroma?

Compression or chronic irritation of this interdigital nerve is the main cause of Morton’s neuroma. Excess pressure exerted on the nerves due to the narrowing of the gap between the toe bones can cause thickening of the nerve tissue from scar tissue formation.

What are the Symptoms 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 (may also radiate to the toes)
• Numbness in the affected toes
• Inability to walk

Wearing high-heeled or narrow shoes squeezes the toe bones and worsens these symptoms.

How is Morton’s Neuroma Diagnosed?

Your doctor can diagnose Morton’s neuroma by examining your foot. Palpation of the foot between the toes may reveal a thickened and tender area. A foot X-ray may be ordered to rule out other bone disorders.

What are the Treatment Options for Morton’s Neuroma?

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 applying ice packs on a towel over the inflamed area to reduce swelling.
• Prescribing anti-inflammatory medications to help alleviate pain and inflammation.
• Sclerosant injections such as alcohol ablation, where highly concentrated alcohol is injected into the neuroma under ultrasound guidance. The alcohol causes chemical destruction (sclerosis) of the fibrous nerve tissue.
• Simple footwear modifications including low-heeled shoes and broad toe box shoes with special pads to minimize discomfort between the toes.
• Physical therapy to relieve pressure and improve the foot function.

Surgery is considered the last option when symptoms fail to resolve with conservative treatments. Other indications for surgery include severe or persistent pain, failure of corticosteroid injections, significant interference with daily activities, or evidence of advanced nerve degeneration.

Surgical treatment involves the release of the compressed nerve by its resection (neurectomy) or removal of the surrounding tissue.