Morton's Neuroma: causes, symptoms and treatments

Common Causes for a Morton's Neuroma

A Morton's neuroma usually forms in response to an injury (such as blunt trauma to the forefoot or direct insult to the nerve), overuse, or repetitive motion of the foot and toes. It usually affects only one foot, though not always.

Over time, the continued compression and irritation of the nerve will cause more severe damage to the nerve and lessen the success of conservative treatments. Many patients come to us after their neuroma has been diagnosed but their doctors were unable to alleviate the pain.

Higher Risk Factors for Morton's Neuroma 

High heels

Wearing high-heels or tight or poorly fitting shoes puts pressure on your toes and the ball of your foot.

High impact sports

Participating in high-impact athletic activities such as jogging or running may subject your feet to repetitive trauma. Sports that feature tight shoes, such as snow skiing or rock climbing, can put pressure on your toes.

Foot deformities

Patients with bunions, hammertoes, extra high arches, or flat feet are more prone to develop Morton's neuroma.

Diagnosing Morton's Neuroma

Often when patients come to us for a second opinion for a neuroma that is not getting better, we discover they have been misdiagnosed and actually have a plantar plate tear of the toe joint.  While they have similar symptoms in the same area of the foot, they are very different conditions with different treatments. Read more about plantar plate tears.

Conservative Treatments for Morton's Neuroma

Remove the deforming force and stop the activity causing the injury

This is an important first step because if you do not remove the cause(s) of the problem, you are simply treating the pain will not fix the actual problem. If your shoes are contributing to the problem, you will need to wear different shoes. If a particular activity is causing the injury, you will need to stop that activity, at least long enough for it to heal.

Immobilization

In some acute cases, immobilizing your foot for a period of time can be very helpful. This is achieved by wearing a special shoe or boot.

Physical Therapy

Physical therapy is another very effective treatment for neuromas in their early stages.

Steroid Injections

In acute cases, treatment may include cortisone injections of cortisone (corticosteroid injections) and can be helpful in reducing pain and symptoms. Local anesthetics can also help alleviate pain.

Custom Orthotics

Custom molded orthotics (also called "arch supports" with special padding is often an important part of treatment and also lessens the chance for the neuroma to return.

Wearing Appropriate Footwear

Patients sometimes get pain relief by wearing lower-heeled shoes (as in NOT high-heels) and shoes with a wide toe box. A wider toe box can alleviate the pressure, so avoid narrow-toed shoes.

Advanced Morton's Neuroma Treatment Options

n more severe and chronic cases that have failed conservative therapies, there are four main treatments available, some more invasive than others. Each treatment below has unique benefits or downsides so each patient has a customized treatment plan that takes into account not only the patient's physical condition but also the day-to-day personal and professional needs. 

Some advanced treatment options for Morton's neuroma are:

Cryotherapy (cryoablation with ultrasound)

This is the method of freezing the nerve. Through a rapid and limited deep-freezing of the affected area, the chronic pain that damaged nerves cause is resolved with a simple and comfortable office procedure. Read more about Cryotherapy.

Alcohol Sclerosis

A special alcohol solution is injected over the nerve. This solution has an affinity only for nerve tissue and the end result is to deaden the nerve. The loss of the nerve can then leave the patient symptom-free.

This procedure stops the nerve from transmitting nerve signals and therefore there is less pain. Most patients respond well to the treatment which is office-based and done under local anesthesia. In certain cases, the procedure does not fully treat the nerve pain on the first attempt and a second treatment may be necessary.

Morton's Neuroma Nerve Decompression Surgery

One of the most recent advances in neuroma therapy is nerve decompression. In many cases, the overlying ligament that connects the metatarsal heads together is pinching the nerve. A simple surgery releases this ligament allowing for increased space for the nerve and relief of pain. This surgery leaves the nerve intact and allows continued sensation to the toes.

Morton's Neuroma Nerve Excision Surgery

This is the most traditional treatment for neuroma pain. This procedure allows for the removal of the nerve from the metatarsal head region and thus decreases or removes pain. There is a risk of the remaining nerve regrowing or scarring but overall, with proper technique, the risk is minimal.

We bury the nerve into a muscle with neuroma surgery which has significantly reduced the stump neuroma issue (a condition when nerve tissue is severed and tries to regrow). By burying the nerve in a muscle in the arch area, the nerve is happy and the chance of regrowth is low.

Why UFAI is the Best Choice for Morton's Neuroma Care

After years of research and studies, done by us and others, we have learned that burying the nerve into the arch musculature dramatically reduces stump neuromas and post-surgical problems. Since a stump neuroma forms when the nerve is looking for something to innervate when we put it in the muscle, the nerve thinks it is doing its job and properly places, thus rarely cause problems.

UFAI's offers the latest diagnostic and curative treatments available. Our physicians have decades of combined experience and the highest success in the nation.

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