Morton's neuroma - Treatment 

Treating Morton's neuroma 

Look after your feet

Your feet take the weight of your whole body, so foot problems can quickly lead to knee, hip and back pain. In this video, a podiatrist talks about the importance of caring for your feet and explains some of the most common foot problems and treatments.

Media last reviewed: 22/11/2013

Next review due: 22/11/2015

Treatment for Morton’s neuroma will depend on how long you've had the condition and its severity.

Simple non-surgical treatments are effective for some people. Others may need surgery. 

Non-surgical treatments

If Morton's neuroma is diagnosed early, treatment will aim to reduce the pressure on the affected nerve. This is usually the nerve between the third and fourth toe bones (metatarsals).

Your GP or podiatrist (foot specialist) may recommend:

  • changing the type of shoes you usually wear – shoes with a wider toe area may help ease the pressure on the nerve in your foot
  • using orthotic devices – such as a support for the arch of your foot to help relieve the pressure on the nerve 
  • painkilling medicationanti-inflammatory painkillers or a course of steroid injections into the affected area of your foot may help ease the pain and inflammation
  • numbing injections – alcohol and local anaesthetic is injected into your foot using ultrasound for guidance; studies have shown that this type of treatment is effective

Resting your foot and massaging your toes may also help to relieve the pain. You can make an ice pack by freezing a small bottle of water and rolling it over the affected area.

Cryotherapy is a new non-surgical treatment that can be used to treat Morton's neuroma. It involves using very cold temperatures to destroy the affected nerve tissue and disrupt its blood supply.

However, there’s no evidence to prove that cryotherapy works and it’s not recommended by the National Institute for Health and Care Excellence (NICE). It is also only available privately.

Surgery

Surgery for Morton's neuroma is usually a treatment of last resort. It may be recommended if you have severe pain in your foot or if non-surgical treatments haven't worked.

Surgery is usually carried out under local anaesthetic, on an outpatient basis, which means you won't need to stay in hospital overnight. The operation can take up to 30 minutes.

The surgeon will make a small incision, either on the top of your foot or on the sole. They may try to increase the space around the nerve (nerve decompression) by removing some of the surrounding tissue, or they may remove the nerve completely (nerve resection). If the nerve is removed, the area between your toes may be permanently numb.

After the procedure you'll need to wear a special protective shoe until the affected area has healed sufficiently to wear normal footwear. It can take up to four weeks to make a full recovery.

Most people (about 75%) who have surgery to treat Morton's neuroma have positive results and their painful symptoms are relieved.

Complications

As with all surgery, complications can occur after having an operation for Morton's neuroma. You should discuss these with your surgeon before having the procedure.

Infection around the toes and thickening of the skin on the sole of the foot (plantar keratosis), which may require further treatment, are two possible complications that can occur following surgery.

Preventing Morton's neuroma

Wearing shoes that fit properly and that have plenty of room in the toe area may help prevent Morton's neuroma.




Page last reviewed: 11/11/2013

Next review due: 11/11/2015

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Comments

The 5 comments posted are personal views. Any information they give has not been checked and may not be accurate.

susieg77 said on 13 December 2013

To those of you wondering about whether to see a podiatrist or a podiatric surgeon, the answer might be both, depending on your symptoms.

I've been experiencing sumptoms of Morton's Neuroma for about 2-3 years, and was first referred to a podiatrist by my GP about 18 months ago. He was rather unhelpful and simply told me that my feet move about a lot. The pain got worse and I went to back to my GP; this time I saw a different doctor at the practice who had an interest in feet. She suspected I had Morton's Neuroma straightaway and referred me to a podiatric surgeon (on NHS).

I saw the surgeon within two months and his view was that my symptoms were most likely as a result of a MN, however they were also probably exacerbated by footwear and the way I walk. He prescribed a two prong approach: firstly, ultrasound scan to confirm if I did indeed have a MN and steroid injection to ease pain, and, secondly, a visit to a biomechanics clinic to be assessed by a podiatrist.

The ultrasound showed that I did have a small neuroma and I received a steroid injection that day. It helped a little, but didn't make a huge difference. What did make a bigger difference was going to see the biomechanic podiatrist, who was much better than the first podiatrist I had seen. She pointed out that I had abnormally high arches, which created a lot of movement and isntability in the foot and had probably contributed to the neuroma. She gave me orthotic insoles for high arches which I walked home in that day and have not taken out of my trainers since. Admittedly, they're quite chunky and can really only be worn in trainers or big boots, however they've made a huge difference. I now make sure I wear them whenever I'm walking more than 5-10 minutes. I now only experience the occasional spikes of pain in the ball of foot when I (occasionally) wear heels to a party or around the office, whereas I used to have pain all day every day, even walking in bare feet
Good luck all!

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Flo 92 said on 01 November 2013

Unfortunately cryo surgery for Mortons nuroma is private, and appears to be only carried out at the BARN Clinic. I have a large nuroma and have been sent to a private hospital under the NHS to have an operation. If I can have operation on NHS at a private hospital, why is Cryo Surgery not an option also? It does seem to have fewer side effects and no chance of a stump nuroma forming after treatment. The poditrist who saw me was not interested in talking through any alternative treatments, only offering the operation. I am undecided on what to do as it should be the last resort.

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lb2 said on 02 June 2013

It's ridiculous that the NHS doesn't offer cryosurgery for this condition. It's minimally invasive and patients can usually return to normal activity after a week. As oposite to 2-3 months in the case of surgery. I imagine surgery costs more money to the NHS as well. So they'd be saving a lot of money by offering cryosurgery.

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Austinabz said on 29 December 2012

Rather surprised to read that a podiatrist said they didn't treat Morton's. I was referred to a podiatrist by my GP and was provided with a orthotic insert which pushes up under my instep. The result has been remarkable. I can now walk for miles with no discomfort. The podiatrist in question said that surgery would be a last resort.

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kazpa24 said on 12 November 2012

This condition can lay undetected (for over 12 year's in my case).
Firstly due to (well I won't go into that). Then after finally getting xrays on both feet I was diagnosed with arthritis. At a later date planter fasciitis.
I've been on tramadol for some time now.
It was only when a friend with a medical background came for the weekend and I yelped with sudden pain he began to question me.
He suggested I went back to my gp and ask him to look at the possibility of Morton's.
I was sent to the podiatrist as suggested here on NHS direct.
However, when I got there I was informed it not them that deal with Morton's. It turns out it should be an orthopedic surgeon.
Please note this to save yourself time on unnecessary waiting lists.

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