This is a painful condition that affects one or more of the nerves between the 2nd 3rd and 4th toes of the foot.
How is it caused?
Irritation and inflammation of the nerve between the bones of the toes cause the nerve to be pinched and the pain occurs.
What are the symptoms?
Pain in the ball of the foot when walking, particularly if walking on tip-toe or in heels. The pain shoots into the toes, but can radiate up the foot. Some people describe the pain as ‘walking on a pebble or stone’. Occasionally a ‘click’ may be felt, which can be painful.
If the neuroma if very large it can cause the toes to separate.
How is it diagnosed?
An appropriate history and examination will raise the suspicion of a Morton’s neuroma.
Ultrasound or MRI can be used to confirm the diagnosis. The benefit of Ultrasound is that a steroid injection with local anaesthetic can be given at the same time.
How is it treated?
For most patients, a steroid injection, with appropriate off-loading of the toes should settle the symptoms quickly. Occasionally custom-made insoles are required to off-load the forefoot.
What can I do?
Wearing shoes that give your forefoot plenty of space and don’t pinch your toes will help to reduce the irritation. Try wearing a lower heel height for a period of time also.
Steroid injection with local anaesthetic
Orthotics or insoles
If a steroid injection and off-loading has failed to resolve all of your symptoms, an operation to remove the neuroma can be performed as a day case.
When can I expect to be back to normal after surgery?
If you are able to work from home, you can do this after a few days.
If you are work in an office at a desk-based job, provided you don’t have any complications with your wound, you should be able to get back to work in around 2-3 weeks.
If you are on your feet all day, or have a long commute where you are standing, you may need 3-4 weeks to fully recover.