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It is usually common in patients who are keen runners or standing on their feet for long periods of time. It may also be exacerbated by wearing tightly fitting footwear.
The main feature on examination is often pain when squeezing the forefoot, thereby compressing the neuroma. There may be a click felt when squeezing the forefoot (a “Mulders click”) which helps confirm diagnosis.
If there is diagnostic doubt, an ultrasound or MRI scan may be performed to clarify the diagnosis.
In the majority of cases, the symptoms of Morton’s neuroma can be managed effectively by non-invasive measures as described below.
Footwear. Wider shoes and foot pads (morton's dome), which fit inside your shoe and help reduce pressure on the nerve. These can be purchased over the counter.
Corticosteroid injection therapy. For individuals with Morton’s neuroma who continue to suffer significant symptoms in spite of using appropriate footwear and orthotics (outlined above), a corticosteroid injection can be offered as the next line of treatment. You can read more about local corticosteroid injections here
Surgical removal of the painful and compressed neuroma is an effective option for patients who:
Although surgery is usually successful, the procedure can result in permanent numbness in the affected toes.
It can be carried out as a daycase under anaesthetic. You will walk with a pair surgical shoes for 2 weeks and you will be invited to attend a follow-up appointment.
In very rare occasions you may have chronic pain as a result of surgery (CRPS), loss of limb and anaesthetic risk. However, these risks are very rare. Please discuss this further with your surgeon.
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