Morton’s neuroma is a medical condition affecting one of the many nerves running between the metatarsals in our foot. Metatarsals are one of the many bones found in the foot. The other bones are the tarsal bones and phalanges with metatarsals being the longest ones. There are a total of five metatarsal bones and the first is the largest and the smallest is the last.
Morton’s neuroma is named after a doctor who first described this condition in 1876 – Dr Morton. It affects the plantar digital nerves running between the metatarsals and usually affects the third and fourth bone. It may also affect the second and third metatarsal bones but this is less common and rarely affects the first and second and fourth and fifth.
Patients suffering from Morton’s neuroma often complain of pain that starts in the ball of the foot all the way to the affected toes. Some patients however will brush it away as toe pain. In some cases, a stinging sensation might also be felt in the toe. The pain will also be felt at the sides of the affected toes. For example, if the third and fourth metatarsal bones are affected, pain will be felt at the right side of the fourth toe and all the way to the left side of the third tone. Symptoms are intensified if patients wear high heel shoes requiring them to walk on their toes and will often go after periods of rest.
Some patients require simple non-surgical treatments while some may need surgery:
- Footwear adjustment might be all that is needed for some patients. This include wearing wide feet shoes to allow room for toes to wriggle, avoiding high heel shoes and having orthotic pads fitted into the shoe.
- Cryotherapy uses extreme cold to destroy neuroma tissues. Through the use of liquid nitrogen, it effectively shrink tissues and inhibit blood flow to the abnormal tissues.
- Steroid injections will deliver a burst anti-inflammatory medication directly to the area
- Sclerosant injections delivers a mixture of alcohol and local anaesthesia to shrink blood vessels and some doctors compare the effectiveness of it to surgery
If non-surgical treatment does not help, surgery will be required. The main purpose of surgery is to make space for the affected nerves due to decompression. The surgeon will make a small incision at the top or sole of the affected foot to relieve the internal pressure. The success rates of surgery is high and long term complications are not common.