What is Morton’s Neuroma?
Morton’s Neuroma is a painful swelling of the nerve running either between the second and third toes or the third and fourth toes. It is often part of a bursa (a soft tissue swelling, often found asymptomatically in feet) and some swelling around the nerve. It is called Morton’s Neuroma because it was first written up in the medical literature by Thomas Morton in 1867. The word neuroma is the medical term used for swelling on a nerve. It is not sinister but can often cause disproportionate pain in the forefoot.
What are the Symptoms of Morton’s Neuroma?
- Pain in the forefoot
- Numbness or tingling in the toes
- Feeling as if you are walking on a pebble
- Feeling if there is something inside your shoe
What are the Causes of Morton’s Neuroma?
No one knows!
There are theories about tight-fitting shoes, particularly ladies’ footwear, repetitive low-grade trauma, such as the frequent wearing of high-heeled shoes, and rarely, injury. However, if this was the case, many more sportsmen would have a neuroma. Most cases are idiopathic.
What are the Risk Factors of Morton’s Neuroma?
We know it occurs more frequently in women, probably because of footwear. Still, lots of ladies wear fashionable shoes and never have any problems! The shape of the feet does not increase the likelihood of developing a neuroma. There are no genetic factors.
Can I Prevent It From Occurring?
As we do not know the cause, we can do little to prevent it from occurring. Of course, if you feel pain in certain (tight fitting) shoes, it would be a good idea to try another pair of shoes!
How is Morton’s Neuroma Diagnosed?
It is largely a clinical diagnosis and is best assessed by a foot and ankle surgeon familiar with diagnosing and treating these.
X-rays are important to exclude a bony cause for the forefoot pain.
Scanning with the ultrasound machine or the MRI scanner does not always confirm the presence, nor can it confidently exclude a neuroma.
Does Morton’s Neuroma Cause Any Lasting Harm?
Not at all, but usually, it becomes enough of a problem that people seek help for the pain.
What is the Treatment for Morton’s Neuroma?
First, seek advice from a foot and ankle surgeon to confirm the correct diagnosis. Once the diagnosis is established, the treatment options are:
- Simple painkillers, such as anti-inflammatories
- Injection of Cortisone
- Surgery to remove the painful nerve
Although a neuroma is painful, there is no need to rush into surgery, and simple measures should always be tried first. Your surgeon will discuss this with you.
What are the Surgical Options for Morton’s Neuroma?
Several options are suggested in the literature. Again, your foot and ankle surgeon will discuss this with you. The most predictable procedure is a short, day-case operation to excise the Neuroma. This will often leave some numbness along the side of the two toes, but to most patients, this is an acceptable compromise to be free of the restrictive pain.
The Foot and Ankle Clinic at the Dubai Burjeel Hospital for Advanced Surgery would be delighted to see and help with your foot pain and discuss available treatments. The first step is to get the correct diagnosis and formulate a treatment plan that you are comfortable with.
Our Orthopedic Foot & Ankle Expert
Dr. Andrew Foggitt
Consultant Orthopedic Foot & Ankle Surgeon
Burjeel Hospital for Advanced Surgery, Dubai