Morton’s neuroma is a condition affecting the foot. It is caused when a nerve in the ball of the foot becomes irritated. The nerve becomes thickened, and this can lead to shooting/burning pains and numbness in the ball of the foot, sometimes extending into the toes.
It is a very common condition and there a number of ways to help reduce the symptoms of the neuroma. These range from simple conservative options and, if required, surgery.
Typical first-line treatment of Morton’s neuroma is to assess footwear. Any footwear which is narrow or pointed will compress the forefoot and therefore cause further irritation to the nerve. Opting for shoes with adequate width and depth, and a cushioned sole, will reduce the nerve compression.
In addition to this, simply changing the way your shoes or trainers are laced can help. By unlacing the trainer completely and then instead of re-lacing from the first set of eyelets, start from the second and then lace as you usually would. This works to reduce compression of the shoes on your forefoot. See out video below for more information on how to re-lace your shoes:
If changes in footwear are providing limited relief, then adding in an orthotic device or insole can help. Commonly, a ‘metatarsal bar’ would be given. The aim of this insole modification is to raise and spread the metatarsals (bones which connect the base of your toes to your foot). This may help to create more space for the nerves which run between each of them. As a result, this reduction in compression of the nerve will therefore reduce any irritation and discomfort.
Other orthotic modifications and advice may be given to address any contributing foot features, such as having highly arched or flat feet.
Another treatment option is a steroid injection. The aim of this is to reduce the inflammation of the nerve and the surrounding tissues. This can also be carried out in conjunction with orthotic therapy.
These injections can be very successful; however, it is possible that the symptoms could return after a few months. In this case, it may be appropriate to have another injection but they are not recommended for long-term use.
Studies have shown that over 80% of people achieve relief from conservative management alone. However, as a last resort, there is the option to have surgery. This is only considered where all conservative management has failed, and symptoms persist. The procedure would involve releasing the ligament which connects the metatarsal heads at either side of the neuroma and removing the affected nerve.
As with any condition, your podiatrist will help you manage your symptoms with your needs and requirements at the centre of the treatment plan.