For Matthew Solan & James Davis at St John & St Elizabeth Hospital and OneWelbeck

For Martin Klinke at London Bridge, Cromwell Hospital, Chiswick Outpatients, New Victoria Hospital & One Welbeck

Morton’s Neuroma

Introduction to Morton’s Neuroma

Morton’s Neuroma is a painful condition that occurs when one or more of the nerves supplying sensation to the toes are squeezed and irritated over a period of time causing scarring of the nerve and in turn more persistent pain in the forefoot (often including a burning pain and feeling of numbness in the affected toes).

This condition causes pain in the ball of the foot that transfers to the toes, and is commonly between the third and fourth toes.

Morton’s Neuroma Symptoms

The main symptom of Morton’s Neuroma is pain. This is generally a shooting, stabbing or burning pain and is often felt under the foot.
The pain has been likened to feeling as though there is a small stone under the foot or in the shoe.

Some people may also experience a tingling or numbness in the foot and the affected area may feel tender to press. There may also be slight swelling of the affected area

The symptoms may be worse when you move your foot or wear tight or high-heeled shoes. It often gets worse over time.

Causes of Morton’s Neuroma

There are many causes of Morton’s Neuroma including:
  • Being overweight putting extra stress on the feet
  • Overuse, for example jobs that involve a lot of standing on hard surfaces, or lots of walking
  • Unsupportive, poorly fitting shoes
  • An enlarged nerve in the ball of the foot (Morton’s neuroma)
  • It can be more common in conditions such as rheumatoid arthritis
  • Altered foot function
  • Clawed or hammer toes can increase pressure on the ball of the foot

Diagnosis for Morton’s Neuroma

Your specialist orthopaedic consultant will talk to you to gain clues from the history of your condition and will then examine you. X-rays and other investigations such as ultra sound scans and magnetic resonance imaging (MRI) may also be required and the surgeon will discuss these with you.
Only when a diagnosis has been made can treatment be initiated.

Morton’s Neuroma Treatment

The method of treatment varies as per the symptoms and severity of the individual’s case.

Treatment for Morton’s Neuroma depends on longevity and severity of the symptoms. Initial treatment of Morton’s Neuroma is usually conservative, non-surgical and simple. The point of these methods is to relieve pain and prevent from recurrence.

  • Changing your footwear
  • Orthotics
  • Corticosteroid injections

If conservative treatments haven’t helped, further options may be considered;

Decompression surgery

In some cases, surgeons can relieve the pressure on the nerve by cutting nearby structures, such as the ligament that binds together some of the bones in the front of the foot.

Removal of the nerve

Surgical removal of the growth may be necessary if other treatments fail to provide pain relief. Although surgery is usually successful, the procedure can result in permanent numbness in the affected toes.

Radiofrequency ablation

Radiofrequency ablation uses an electric current to heat up a small area of nerve tissue to stop it from sending pain signals. It can provide lasting relief for people with chronic pain.

Calf release

Calf muscle release is a surgical procedure involving the surgical release of the calf muscle by making an incision in the back of the leg to gain access to the calf muscle which is then cut to release tension in the calf muscle.

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    Consultant Surgeons

    Our specialist team at the London Foot and Ankle Centre is comprised of five consultant orthopaedic surgeons, focusing entirely upon the foot and ankle.