Morton's Neuroma (also known as Plantar Digital Neuritis) is a common condition affecting around 1 in every 2,000 people. Footwear is thought to be the cause of most cases, although it can also be caused by direct trauma to the foot. It's not really a neuroma at all but was originally believed to be one and the name has stuck. A neuroma is a growth on a nerve and that is not what is happening here. Instead there is a swelling of the nerve itself and that is why the alternative name of plantar digital neuritis is a more accurate description of the condition.
Symptoms include a sharp pain and/or burning in the ball of the foot. Some patients find the pain can be eased by removing the shoes and massaging the area. The pain is usually intermittent but as the condition worsens it can become constant. The pain can come at any time but is most common when walking or running and especially when wearing tight-fitting shoes. Most commonly, the pain is felt between the third and fourth toes, but it can occur between any toes. Women are affected much more than men and the condition is only rarely seen in children, but anyone of any age can suffer from this condition.
manipulation is the treatment we use most often for Morton's neuroma. We have found it to be a highly effective treatment for this condition. Ocassionally, having the foot manipulated can be momentarily uncomfortable but this passes quickly. Relief from your foot pain is normally felt immediately after the first treatment, although this is quite short lived initially - around an hour. With subsequent treatments the relief will last longer until finally there should be little or no pain at all. On average, this takes from 6 to 8 treatments, but each case is different and this can vary slightly from person to person. For more information about manipulation, what to expect and how it works, click here.
Orthoses are specially made insoles which are designed to hold your foot in the correct position, thereby eleviating your pain. They are commonly used in the treatment of Morton's neuroma. They can be made to fit most shoes, but if you regularly wear high heels or court shoes then this can limit the effectiveness of orthoses. Sometimes they can take a little getting used to and can take up room in your footwear. Your podiatrist will take a series of measurements from your foot and design an orthotic to offer the best control possible. For more information about orthoses and how they work, click here.
Steroid injections have been shown in some studies to offer good short-term relief, whilst other studies have suggested that they are of little benefit. There is no evidence that this treatment is a good long-term solution for Morton's neuroma. If other conservative treatments have failed to provide you with any relief then a steroid injection is something you may wish to consider in order to give you some short term pain relief while you are waiting for surgery.
Surgery should only be considered if all other conservative treatment options have already been explored. In our experience, surgery is very rarely needed for Morton's neuroma. If after consultation with our podiatrist you feel that the surgical option is best for you, we will be happy to refer you to a podiatric or orthopaedic surgeon. Surgical intervention usually involves the removal of the affected nerve, leaving a small numb patch near the affected toes. For most people this is not a problem and it is a feeling they get used to with time.