 |
 |
| Figure 1 –The swelling can be seen on the nerve between the third and fourth toes |
High Arch (Cavus) Foot | Flat Feet | Foot Swellings | Foot Arthritis | Heel Pain
Mortons Neuroma | Rheumatoid Arthritis
Morton's Neuroma
Introduction
Morton’s neuroma occurs as a result of pain and swelling in the region of one of the nerves in the forefoot. It was first described by Thomas Morton in the late 19th Century. It occurs as a result of entrapment of the nerve between 2 of the bones in the foot known as the metatarsals.
Symptoms
The most common symptom is pain. This is usually between the 3rd and 4th toes, although Morton’s neuroma can occur between other toes as well. There may be a shooting electric shock type pain into the toes with changes in sensation. Symptoms are often worsened by wearing tight fitting shoes or high heels. You may feel pressure under the ball of the foot with a feeling of having something in your shoe when you walk.
Diagnosis
The diagnosis of Morton’s neuroma can be difficult. In general, the most accurate diagnosis is made by taking a good history of the symptoms and a thorough clinical examination. Occasionally we will carry out special scans such as ultrasound or MRI scan, although these are often inaccurate in diagnosing this particular condition and are not always used.
Treatment Options
1. Non operative treatment
Shoe modification and/or orthotics, which is an insole in the shoe, may help to reduce the symptoms. Occasionally an injection will be offered. Whilst this usually only gives temporary relief it is often useful in cases where the diagnosis is not certain.
2. Surgical treatment
Surgery for Morton’s neuroma involves removal of the neuroma and surrounding nerve. This can be performed through a cut either on the top of the foot or on the sole of the foot and this will be discussed with you by Mr Taylor or Mr Farrar when you attend for your outpatients consultation. The success rate from surgery is good with up to 90% of patients having significant reduction or resolution of their pain. There is usually an area of numbness between the toes as a result of the nerve being removed, although this is not usually troublesome and patients are in general grateful to be rid of their pain. There is a risk of recurrence of the neuroma in the long term which may occasionally require further surgery.
