Morton’s Neuroma
Common nerve condition causing forefoot pain and treatment options
A Morton's neuroma is a thickening and fibrosis of the tissue that surrounds the digital nerve leading to the toes. It commonly affects:
- 3rd intermetatarsal space (nerve supplying 3rd and 4th toes)
- 2nd intermetatarsal space (nerve supplying 2nd and 3rd toes)
Trauma, irritation or excessive pressure on the nerve causes it to swell and thicken, thus creating a neuroma.
Symptoms
Patients may experience:
- Pain on weightbearing
- Sensation of walking on a pebble or stone
- Burning sensations
- Numbness
- Sharp shooting pains
Pain can be exacerbated by tightly fitted or high heeled footwear.
Treatment Options
Conservative Treatment (First Line)
-
Footwear changes
-
Lower heel height
-
Broader toe box to reduce nerve pressure
-
Orthotic therapy with appropriate padding
-
Helps with biomechanical issues
-
Offloads painful area
-
Manual therapy
-
Mobilisations
-
Dry needling/acupuncture
-
Low level laser therapy
-
Ultrasound
Advanced Treatment
If conservative treatment fails:
- Injection therapy under ultrasound guidance (works well with orthotic therapy)
- Surgical removal of affected nerve portion (if all other treatments fail)
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