Can a Morton's Neuroma of the Foot Be Cured?

If you’ve ever experienced pain in the ball of the foot, then someone may have suggested Morton’s neuroma is the problem. While there are several causes of forefoot pain, Morton’s neuroma remains one of the most common causes. People with neuroma often get frustrated because they take a long time to become pain-free and sometimes require surgery.

In simplest terms, Morton’s neuroma is an inflamed nerve that occurs on the ball of the foot (bottom), just behind the 3rd and 4th toes. The nerve seems to get irritated by the surrounding bones (metatarsal bones) and has also been termed an intermetatarsal neuroma. What starts as inflammation, can result in scar tissue forming around the nerve and in some cases enlargement of the nerve. This nerve is particularly sensitive to excessive pressure on the foot, and also occur in women who wear high heels and tight-fitting shoes. Morton’s neuroma symptoms involve pain, swelling, numbness, tingling, and/or burning. A common patient complaint is a sensation of walking on a rolled up sock.

Treatments vary according to the severity of the problem:

• RICE (rest, ice, compression, and elevation).
• Padding. Cushioning to the ball of the foot may lessen symptoms, and off-weighting pads may be effective.
• Orthotics. Arch supports may better align the foot and take the pressure off the nerves.
• Anti-Inflammatory Medications. Medications that decrease inflammation may reduce pain.
• Injection Therapy. There are two types of injections, cortisone injections and alcohol injections for Morton’s Neuroma. A local cortisone injection is a powerful anti-inflammatory medication to quickly reduce inflammation. Cortisone injections may be administered once every 6 to 8 weeks for a few injections for efficacy. Alcohol injections also called sclerosing injections, are injected to “deaden” or ‘deactivate” the nerve.

When all else fails, the Mortons neuroma can be treated with surgery, and the best techniques today are listed below:

1. Morton’s Neurectomy: This is the most common approach, which most commonly involved removing the nerve segment. The procedure is generally straightforward. Surgeons generally approach the area from the top of the foot, identify the nerve and follow it towards the toes and as it courses through the metatarsal bones. It is important that the surgeon cut the nerve far enough back to avoid the nerve from becoming entrapped or scarred on the ball of the foot. Some surgeons approach neuromas from the bottom of the foot for direct visualization but require a scar on the bottom of the foot - which can become painful to walk on.
2. Decompression: Another approach that some surgeons utilize is to release a ligament adjacent to the nerve to “decompress” the area. Here the nerve is left intact. The procedure is performed with small specialized instruments.

Like any medical issue, some treatments work for some patients and fail in others. The most important aspect of treating Morton’s Neuroma properly is to be sure that the diagnosis is correct. Bunions and hammertoes are known to transfer weight onto the ball of the foot and inflame nerves, causing a resultant Mortons Neuroma. The best cure for a Mortons neuroma is to be sure that you have a proper diagnosis, and that other conditions are not causing the neuroma.

Morton’s neuroma generally responds well to conservative treatments, and for resistant cases, surgery can be effective.