Morton's Neuroma

Morton's neuroma is a painful foot disorder which usually occurs on the sole of the front of the foot, in the area between the third and fourth toes. In the initial stages, sharp, intense dragging pain generally occurs mainly during weight-bearing (walking) and when wearing shoes. The sensation is often described as "walking on pebbles". Taking off the shoes and elevating the feet generally relieves the pain.

Compression of the fine nerves running from the ball of the foot and toes to the skin is the underlying cause of the pain. The nerves in this region respond to constant pressure (due, for example, to a foot deformity) by becoming inflamed and swollen. The result is pain.

Magnetic resonance imaging (MRI) is the most reliable method of diagnosis.

As a rule, conservative treatment is attempted first. Custom orthotic inserts, designed to take the pressure off the front of the foot, and measures for correction of the foot deformity are central to treatment. Medications to reduce pain and inflammation should also be used. Injection therapy (injection of long-acting cortisone directly into the painful site) is another option. Should this wide range of conservative treatment options fail, then surgery may be the last resort. Surgical access is obtained through a small skin incision made either on the sole of the foot or on the top of the foot. The irritated nerve fibres are then removed. After surgery, weight-bearing is not permitted on the front of the foot for a short time until the wound has healed.