Neuroma Fundamentals

A Morton’s neuroma is swelling in the nerve or inflammation around the nerve at the base of the toe. Pain occurs in the two adjacent toes. The nerve affected by Morton’s neuroma runs from the foot surface to the toes. Due to the pressures of walking, standing and wearing shoes, severe, intermittent pain can occur in the ball of the foot. Some patients also experience numbness in the toes or sharp, sudden pains.

What causes Neuroma?

  • Chronic foot injuries.
  • Biomechanical problems, such as bunions or foot pronation.
  • Genetics, including inheriting flat feet.
  • High-heeled shoes with pointed toe boxes.
  • Ill-fitting shoes.
  • Rheumatoid arthritis or gout.
  • Repetitive trauma, such as that caused by jogging.
  • Pregnancy.

Symptoms of Morton’s Neuroma include:

  • Pain in the ball of the foot.
  • Pain and/or numbness between the toes.
  • Clicking sensation when walking.
  • Sharp, tingling pain.
  • Pain after jogging.
  • Pain relief after removing one’s shoes.

How is this treated?

Non-surgical

  • Wearing shoes with a roomy toe box.
  • Treat biomechanical conditions, such as bunions.
  • Rest the foot and apply ice after activity.
  • Take anti-inflammatory medications.
  • Wear a foam pad under the toes or between the toes.
  • Obtain an injection of xylocaine and cortisone in the affected area in an attempt to clearly diagnose the condition and also reduce the symptoms by decreasing the inflammation in the area.
  • Wear shoe inserts.

If the above treatments do not relieve the pain, your doctor may recommend surgery.

What are the risks of treatment?

Surgery for Morton’s neuroma consists of removal of the affected nerve prior to its branching to the toes. Risks of surgery include infection, toe stiffness, or a recurrent neuroma. Numbness will result since the nerve is removed. However, over time, numbness typically becomes negligible.

Rehab after surgery

Slowing increasing one’s weight-bearing and normal activities is encouraged. Massage of the incision and forefoot is helpful. Formal rehabilitation is not usually necessary.