Morton's Neuroma: causes, symptoms and treatments

Updated 4/11/2019
We explain Morton's Neuroma and UFAI's new progressive treatments.

What's Morton's Neuroma?

 

A neuroma is a benign growth (not actually a tumor), but a thickening of the tissue and inflammation of nerve tissue. A Morton's Neuroma is a neuroma that's causes foot pain in the ball of the foot (usually between the third and fourth toes). It's also called an "intermetatarsal neuroma" Intermetatarsal explains its location, between the metatarsal bones in the ball of the foot.

 

A Morton's neuroma is often described as feeling like you are standing on a pebble in your shoe, a shooting pain or like a big fold in your sock that you are constantly walking on. You may also have burning pain or numbness and foot. It usually a very painful condition.

Common Causes for a Morton's Neuroma


A Morton's nueroma usually forms in response to an injury (such as a 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

UFAI patient Bill talks about his Moton's neuroma surgery and what a difference it's made in his life .

 

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 the 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 boxes. 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 patients physical condition but also the day-to-day personal and professional needs. 

 

Some advanced treatment options for Morton's neuroma are:

 

Cryotherapy

This is the method of freezing of the nerve. Using ultrasound guidance, a small incision is made over the area of the nerve. A wand from the cryotherapy device is inserted into the wound and placed over the nerve. The device is set to a specific amount of time during which it freezes the nerve. 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 removal of the nerve from the metatarsal head region and thus decreases or removes pain. There is risk of the remaining nerve regrowing or scarring but overall, with proper technique, the risk is minimal.

 

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 is properly places, thus rarely causes 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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  • Foot and Ankle Surgeon and Director of University Foot and Ankle Institute
    Dr Bob Baravarian, University Foot and Ankle Institute

    Dr. Bob Baravarian is a Board Certified Podiatric Foot and Ankle Specialist. He is currently a member of UCLA Medical Group, Chief of Podiatric Surgery at Santa Monica/UCLA medical center and Orthopedic Hospital and an assistant clinical professor at the UCLA School of Medicine. He also serves as Director of University Foot and Ankle Institute.

     

    Dr. Baravarian has been involved in athletics his entire life and played competitive tennis in high school and college. He has an interest in sports medicine, arthritis therapy and trauma/reconstructive surgery of the foot and ankle. He is also fluent in five languages (English, French, Spanish, Farsi and Hebrew),

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