Overview
What is Morton’s Neuroma?
A neuroma is a benign tumor of a nerve. Morton’s neuroma involves a thickening of the tissue around one of the nerves leading to your toes. It may also be referred to as interdigital neuritis, interdigital neuroma, interdigital nerve compression syndrome. Morton neuroma is common in middle-aged women, and the incidence is at least 5 times more common in females when compared to men.
Symptoms
Morton’s Neuroma Symptoms
Morton’s Neuroma can cause a wide range of symptoms.
- Burning
- Tingling
- Numbness
- Reduced sensation
- Feeling of a pebble in your shoe
- Feeling like your sock is scrunched up inside your shoe
- Radiating pain through your foot
How Do You Get Morton’s Neuroma?
There are several different factors that can cause the presence of a Morton’s Neuroma. These include, trauma from an injury, the biomechanics of how your foot is moving, or footwear.
Certain foot deformities including the presence of bunions, hammer toes or flatfeet can cause increased irritation to the area. Pronation of the foot may cause the heads of the metatarsal bones to rotate slightly, thereby pinching the nerve running between the metatarsal heads. This increased pressure or pinching causes the nerve sheath to enlarge which can lead to worsening pain over time, if not addressed.
The two most common causes we see for the development of a Morton’s Neuroma are wearing shoes that have a narrow toe box or high-heeled shoes. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running or court sports. An injury or other type of trauma to the area may also lead to a neuroma.
Aside from shoes, running with poor biomechanics can also trigger this neuroma to develop. Nerve damage can occur when there is enough repetitive impact therefore running without proper support will cause swelling around the nerve. Incorrect running technique with inadequate shock absorption may also lead to a Morton’s Neuroma.
The Morton’s Neuroma Test
Diagnosis of Morton’s Neuroma is usually based on history and clinical examination by one of the PEAK Podiatrist’s. You do not need to see a GP before coming in for an appointment. Palpation in the affected area may reproduce the symptoms. Compression of the forefoot direction while palpating the affected space often results in a significant crunching or clicking feeling, commonly known as the “Mulder’s click.” When we hear the clicking sounds, this is the first sign that there is instability in the foot causing hypermobility in the joint.
Your PEAK Podiatrist will be able to write an ultrasound or MRI referral if they believe imaging of the area may be beneficial.
Morton’s Neuroma Treatment Options
There are several different treatment options your PEAK Podiatrist is able to help provide for the treatment of Morton’s Neuroma. The treatment options depend on several factors, including the severity of symptoms and how long they have been present. Some of the options include:
- New footwear advice
- Offloading the area with custom foot orthotics and/ or a metatarsal dome
- Intrinsic muscle strengthening
- Massage and dry needling
- Consideration for a cortisone injection if symptoms persist
Injections
Injections for Morton’s Neuroma is one treatment option. The most common is a corticosteroid injection. A steroid injection may help reduce some inflammation and pain at the neuroma site, however it does not remove the neuroma. Your PEAK Podiatrist’ will be able to provide a comprehensive initial assessment and start to provide you with conservative treatment options. If it is warranted your Podiatrist may refer you to a doctor to get a referral for an ultrasound guided corticosteroid injection. In most cases conservative treatment options such as footwear advice and orthotics will be sufficient to help manage symptoms.
Physio
Morton’s Neuroma can be seen by Physiotherapists, however is more commonly managed by our musculoskeletal Podiatrists who specialise in the foot and lower limb. Your PEAK Podiatrist will be able to provide more detailed information on footwear and custom foot orthotics if required.
Surgical Treatment
Surgical intervention may be an option for Morton’s Neuroma if more conservative methods have not settled symptoms after 12 months. Surgery may involve either removing the nerve, removing the pressure on the nerve by cutting surrounding ligaments or fibrous tissue or cryogenic surgery where the nerve is frozen from extremely cold temperatures.
Cryosurgery
Cryosurgery treatment for Morton’s Neuroma is not a common treatment option. We do not offer this service at our PEAK clinics. For this treatment option your PEAK Podiatrist will collaborate with your GP doctor to determine the best options for this treatment if it is explored as an option for your specific complaint. At PEAK we specialise in conservative treatment options such as offloading through custom foot orthotics, footwear advice, hands on therapy and review of biomechanics unless we believe you need to explore other alternatives.
Massage
Massage is an effective treatment technique to help with symptoms of Morton’s Neuroma. Massage is able to reduce muscle tension in the foot and lower leg as well as assisting to mobilise the metatarsal heads. It can also be a helpful treatment for muscle tightness of the entire body potentially caused by adjusting your walking gait due to pain from the Morton’s Neuroma.
Running
Morton’s Neuroma is a very common condition we see in runners. Running causes repetitive irritation to the ball of the foot and can cause compression to the nerves. It is common for runners to present complaining of numbness, tingling or burning pain in their forefoot several kilometers into their run.
There are several factors that can increase the presence of a Morton’s Neuroma including running technique, footwear and the biomechanics of the forefoot. Your PEAK Podiatrists are able to provide comprehensive running assessments to identify opportunities to reduce load to the forefoot. Your PEAK Podiatrist will also review your current footwear and provide recommendations for the most appropriate running shoe.
Meet our Morton’s Neuroma Treatment practitioners
FAQs Frequently Asked Questions
Pain from a Morton’s Neuroma will not always strictly be worse in the morning. However, as the injury becomes more severe it is common for your pain to be more constant, beginning in the mornings and remaining throughout the day. Effective treatments can include offloading through custom foot orthotics, footwear advice, massage therapy and review of biomechanics.
Some side effects following Morton’s Neuroma Alcohol injections include pain at the injection site, numbness, increase in sensitivity or local tissue scarring of the injection site. We do not provide Alcohol Injections at any of our clinics. Other successful treatments we offer include offloading through custom foot orthotics, footwear advice, massage therapy and review of biomechanics.
There is a possibility in some cases that Morton’s Neuroma may grow back. We find we have successful treatments with conservative treatment options such as offloading through custom foot orthotics, footwear advice, hands on therapy and review of biomechanics.
For treatment of Morton’s Neuroma it is recommended to see one of our PEAK musculoskeletal Podiatrist’s. Our Podiatrist’s specialise in injuries below the knee and have vast knowledge on footwear, gait retraining and custom foot orthotics.
Morton’s neuroma involves a thickening of the tissue around one of the nerves leading to your toes. The inflammation can be reduced with certain treatment’s and they often have very effective results. However there is no guarantee the nerve will remain pain-free forever.
Surgery for Morton’s Neuroma is not often considered unless conservative treatment options have been used for a minimum of 6-12 months. Unfortunately the surgery is not always successful. Some post surgery complications may include the pain returning, numbness or poor wound healing. Recovery post surgery is often 4 weeks, however it can be up to 4 months if there are complications.
Our locations
Hawthorne
PEAK Hawthorne opened in 2012 and was extended and renovated in 2020. You see the same team whether we see you at Hawthorne or one of our other clinics. Hawthorne offers private treatment rooms and a spacious exercise area incorporating the latest equipment and technology, unrestricted single level access and off-street parking. We also provide HICAPS for real-time private health claiming.
Our locations
New Farm
PEAK New Farm opened in August 2019. You see the same team whether we see you at New Farm or one of our other clinics. New Farm offers private treatment rooms and a spacious exercise area incorporating the latest equipment and technology, unrestricted single level access and off-street parking. We also provide HICAPS for real-time private health claiming.
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Hawthorne
- Phone: (07) 3399 3318
- Fax: (07) 3319 6577
Address
5/171 Riding Road,Hawthorne, QLD, 4171 Get Directions
Opening Hours -
6 days per week
- Monday - Friday: 7:00 am - 8:00 pm
- Saturday: 7:00 am - 1:00 pm
To make a booking outside of business hours, please use our form by clicking here.
New Farm
- Phone: (07) 3399 4668
- Fax: (07) 3319 6577
Address
1/15 Lamington Street,New Farm, QLD, 4005 Get Directions
Opening Hours -
6 days per week
- Monday: 7:00 am - 8:00 pm
- Tuesday: 7:00 am - 8:00 pm
- Wednesday: 9:00 am - 8:00 pm
- Thursday: 10:00 am - 8:00 pm
- Friday: 7:00 am - 3:00 pm
- Saturday: 7:00 am - 3:00 pm
To make a booking outside of business hours, please use our form by clicking here.