Morton’s Neuroma Treatment
Mortons Neuroma Treatment Information
Many people are interested to learn about Morton’s neuroma treatment options, as it is a common and usually very painful condition. The condition has many names: Morton’s metatarsalgia, Morton’s disease, Morton’s neuralgia, plantar neuroma, or intermetatarsal neuroma, however all these describe the one same condition: a non-cancerous (benign) growth of nerve fibres that develops usually between the third and fourth toes of the foot.
Morton’s neuroma causes pain in the ball of the foot. Patients often describe the pain as a “burning hot needle”, which can start suddenly during walking. There may be numbness of the toes and pins-and-needles (medically referred to as paresthesia).
Morton’s Neuroma Treatment Options
The Morton’s neuroma treatment of choice will be determined by your specialist podiatrist, following close consultation with you, and will largely depend on a variety of factors such as the severity of your symptoms, how long these symptoms have been present, and whether or not any conservative treatment has been tried.
The earlier the condition is diagnosed, the sooner the Morton’s neuroma treatment can begin, and the less likely it is that surgery will be required to treat the condition. Usually, home treatments, or conservative therapies will be suggested as a first attempt to relieve the pain.
Morton’s neuroma conservative and home treatments:
Conservative and home-remedies for Morton’s neuroma treatment are based upon the principle of reducing pressure on the neuroma in order to reduce the level of pain. Some of these treatments may include:
- Resting and elevating the foot above the level of the heart
- Gently massaging the sore foot and toes
- Applying a wrapped ice pack to the area
- Choosing shoes with a wide fit, to allow the toes to spread out comfortably and reduce pressure inside the shoe
- Strengthening or stretching the structures in the toe with appropriate exercises prescribed by your specialist podiatrist
- Using over the counter NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen, to reduce inflammation and pain
- Managing your bodyweight, as this can improve pain symptoms by relieving the pressure on the feet caused by carrying excess bodyweight
- Using arch supports or foot pads/inserts that are custom-made by your podiatrist to appropriately support your foot, if they are suitable for your condition.
Morton’s neuroma treatment: injectables
In cases where the pain is severe and symptoms are persistent, your podiatrist may recommend corticosteroid or alcohol sclerosing injections as a form of Morton’s Neuroma treatment.
- Corticosteroid injections:
These are steroid injections that can be injected directly into the site of the Mortons neuroma. They work to reduce pain and inflammation. There is generally a limit as to how many injections are recommended, as there are some possible side affects with these.
Alcohol sclerosing injections:
Studies on the efficacy of Morton’s neuroma treatments have demonstrated that alcohol injections at the site of the neuroma can reduce the size of the growth as well as relieve the pain.
Mortons neuroma treatment: surgery
Surgery may be advised in cases where other Morton’s neuroma treatments have been tried to no avail, and painful symptoms have persisted for 9-12 months. Surgical treatment involves removing the bundle of nerve fibres or relieving the pressure on the painful nerve by cutting the surrounding ligaments or fibrous tissues. Surgeons may take one of two approaches: the dorsal approach, or the plantar approach. There are benefits and drawbacks to each, but generally, with a dorsal approach, the surgeon makes their incision at the top of the foot. This means that the patient is able to walk almost immediately following surgery (since the stitches are at the top). With the plantar approach, the incision is made in the sole of the foot. This way, the neuroma can usually be easily accessed and removed without disturbance to the surrounding tissues, however stitches in the bottom of the foot mean that the patient is generally on crutches for around 3 weeks following surgery. For some patients, the resulting scar tissue from the surgery makes it uncomfortable to walk. All surgeries carry some risk of infection and the potential for some resulting side effects. Your surgeon will discuss these details with you prior to choosing to undergo surgery for your Mortons neuroma treatment.
What to Expect Following Morton’s Neuroma Treatment
Individual recovery times will vary depending on the severity of the condition and which Morton’s neuroma treatment the patient has received. For some patients, simply changing their footwear to something wider or less tight, or using over the counter pain killers is enough to relieve their pain over time.
Recovery times following surgical Morton’s neuroma treatment vary. Recovery is usually quite fast with nerve decompression surgery, and often the patient is able to walk almost right away with the comfort of a padded shoe. In surgeries where the growth is removed, recovery time may be 1-6 weeks, depending on where the incision is made and whether or not crutches are required to assist walking. In both cases, it is recommended that the affected foot is elevated above the level of the heart as often as possible throughout the day, and the foot must be kept dry to allow the wound to heal.
In a small number of cases, Morton’s neuroma may recur following the initial treatment.
Please note that the information detailed in the article above should not be taken as general advice and is for informational purposes only. If you have been diagnosed with Morton’s neuroma and wish to discuss your options for Morton’s neuroma treatment, then you should consult with an appropriately qualified podiatrist to discuss your concerns. Appointments can be made online at sydneypodiatrist.net.au or by calling 02 93883322.
Karl Lockett – sports podiatrist.