What is it?

Morton’s neuroma is a painful swelling on a nerve in the forefoot.  It is a reasonably common cause of pain in the forefoot which sometimes shoots into the toes and can cause pins and needles and numbness in the toes.  It is a benign swelling and not malignant.

What causes it?

The nerves which supply the toes can get trapped and rubbed between the heads of the metatarsal bones on the foot.  Constant rubbing  causes the nerve to become inflamed and scar tissue forms around the nerve.   The situation can be made worse by tight shoes, high heel shoes and activities such as running which load the forefoot repetitively.

How is it diagnosed?

The diagnosis is often made through the history and a thorough clinical examination.  The clinician can often feel the lump inbetween the toes and a painful clicking sensation is reproduced on squeezing the forefoot.  If there is any doubt as to the diagnosis an ultrasound or MRI scan is usually requested.

How is it treated?

Treatment involves activity modification and a custom made shoe insert to offload the area.  If caught early the problem may respond to a targeted steroid injection however the effect may not be permanent and complications can occur (skin discolouration, toe capsule damage and toe deviation).

If the problem is chronic then we may advise excision of the neuroma, a day case procedure performed through a small incision on top of the foot.