Morton Neuroma

Anatomy/Symptoms
This painful condition is a small benign swelling of the nerve (neuroma) under the forefoot, usually between the third and fourth toes. Symptoms of this condition include sharp pain, numbness or burning sensations in the ball of the foot.

Morton’s neuroma is believed to be a result of chronic injury to the nerves of the forefoot, which are trapped in the wall of the inflamed bursa between the metatarsal heads. Women are more likely to develop this condition as high-heeled shoes or pointed toe shoes can create the pressure or irritation of the nerves in the foot leading to the development of a neuroma.

Non-operative Treatment
Conservative measures used to treat Morton’s neuroma include:

• Replacing narrow-toed shoes with shoes that have a wider space for the toes
• Resting the foot after activity or exercise
• Non-weight bearing exercises
• Cortisone and local anaesthetic injections into the area.

Operative Treatment
If conservative treatment does not give adequate relief from symptoms, nerve transposition may be recommended. An incision is made on the top of the foot; the nerve is released and moved (transposed) from the underside to the top of the foot. This is performed as day surgery.

Post-operative Treatment
Following surgery, rest, elevation of the foot, and the use of crutches is required. The first 1-2 weeks should be spent largely resting, walking only for necessity. Resolution of the pain and swelling usually takes 6-12 weeks.

Risks/Complications
Complications of this surgery include:

• Numbness to one or more of the toes
• Persistent pain
• Wound infection
• Blood clot