Morton’s Neuroma
What is it?
A morton’s neuroma is an irritation of a nerve bundle in your forefoot, this irritation can cause some inflammation in the nerve which causes you pain.
Most common symptoms:
- Pain when you stand up for long periods of time
- Pain when you stand on your tip-toes
- Pain when you walk
- Feels like a pebble beneath the ball of your foot
- Burning, tingling or numbness in the area
Why does this happen?
Morton’s Neuromas can occur for a wide variety of reasons and some are still not known.
The main cause is a change in footwear, or continual wear of narrow footwear.
As you can see from this photo below, If you continuously wear narrow footwear, your foot bones get pushed together. This creates a narrow space for the nerve to be in. This continual narrow space causes an inflammatory response in the nerve. The nerve can also become slightly thickened which increases irritation and pain when you walk/stand on your tiptoes.
How is it treated?
The key to treatment for this condition is an accurate diagnosis. There are a number of conditions that affect the forefoot area and the treatment does differ depending on the condition.
Scans:
Typically we will organise an ultrasound scan to determine the extent of the neuroma and the exact location. Ultrasound scans by the right radiologist can very accurately assess the area and provide significant details that are vital in creating an effective treatment plan.
Conservative Management:
Our initial focus is to manage this conservatively. This involves taping, shoe additions such as metatarsal domes, rigid footwear or orthotics. The main focus is to quickly reduce pressure on the affected nerve and allow the surrounding tissue to settle down. Occasionally a course of anti-inflammatories can help this process.
We find in most cases conservative management can effectively reduce the pain and provide a very satisfactory long term solution. However in some case further interventions may be required.
Injection Therapy:
Cortisone (steroid) injection is a common treatment for Morton’s neuroma and has been shown to be effective. We recommend if it is necessary, to have the injection guided by ultrasound by a recognised radiologist who specialises in this area. Another option is radiofrequency ablation therapy that involves a heated needle being inserted into the neuroma and cauterising the neuroma itself.
Surgery:
For persistent cases that do not resolve, then surgery can be recommended. The surgery involves removing the neuroma and is shown to have a high success rate to resolve the symptoms. Like any surgery is does have inherent risks but for cases that don’t respond to conservative management or injection therapy then this is an option that can be considered.
If you suffer from forefoot pain then we can help! At our Essendon or Blackburn clinics, we can accurately assess and diagnose the cause of your pain through our experienced practitioners and referral partners. We have excellent relationships with the best radiologists in Melbourne and have a Sports Physician on site who can provide injection therapies if required.
