Morton's neuroma

What is it?

A Morton’s Neuroma is a thickened nerve that presents between the long bones (metatarsals) of your foot. Although they can occur between any of these long bones, the most common location is between the 3rd and 4th metatarsal heads. Despite being variable between patients, the most common presenting complaints are burning, tingling and numbness within the area and it is not uncommon to feel referred pain into the toes.

Risk factors:

• Increased pronation

• Hypermobility

• Hypertrophic (enlarged) nerves

• Poor Footwear

• Collapsed transverse arch

• Always on feet.

Symptoms:

Typically, there's no outward sign of this condition, such as a lump. Instead, you may experience the following symptoms:

• A feeling as if you're standing on a pebble in your shoe

• A burning pain in the ball of your foot that may radiate into your toes

• Tingling or numbness in your toes

How is it diagnosed?

 A thorough history/clinical examination will generally be sufficient for the diagnosis of a Morton's Neuroma. Depending on the severity of your symptoms, you may be referred for an ultrasound to confirm the diagnosis/rule out further pathology.  Careful diagnosis is required, as there are several conditions in the forefoot which present with similar symptoms.

Treatment options:

• Rest/Ice

• Padding

• Strapping

• Footwear advice

• Metatarsal domes

• Custom Orthotics

• Corticosteroid injections

• Surgery

Prognosis:

Generally speaking, successful results are often achieved with the correct footwear advice and custom orthotic devices are often prescribed to offload the nerve and improve biomechanical risk factors. Cortisone injections & surgery are reserved for extreme cases and are rarely indicated.