Morton’s neuroma is actually a misnomer, as it describes a condition that is not a neuroma. Morton’s neuroma is actually fibrous tissue formation (perineural fibrosis) found around a plantar foot nerve. It is most commonly found between the 3rd and 4th OR 2nd and 3rd metatarsal heads (the ball of the foot near the corresponding toes).
What Are The Symptoms Of
Pain or numbness is found under the ball of the foot between the 3rd and 4th OR 2nd and 3rd metatarsal heads.
Sometimes patients will complain of shooting pains to the toes or even going up the foot.
Some patients describe the sensation of having a pebble in their shoe. Morton’s neuroma pain can often be alleviated by removing your footwear.
How Are Morton’s Neuromas Treated Conservatively?
- Wider shoe gear
- Custom molded orthotics with neuroma specific padding
- Corticosteroid injections (with or without ultrasound guidance)
- Sclerosing alcohol injections
- Physical therapy
- Extracorporeal shock wave therapy is an alternative to surgery often used when conservative treatment fails. This treatment involves using low dose sound waves to incite an inflammatory response in the tendon which starts a healing cascade where the body heals itself. It offers a treatment option with cure rates similar to surgical management with the benefit of no anesthesia, no incisions, and minimal to no after treatment disability.
What Are The Surgical Options for Morton’s Neuroma?
Cryoprobe surgery (also known as cryogenic neuroabliation) cyclically freezes the neuroma to degenerate the axons that carry the painful impulses while using a eraser sized incision. This is performed in the office. The benefit of this treatment is the small incision and the lack of stump neuroma formation that neurectomy does.
Neurectomy involves excising the involved nerve tissue. This is the last option for treatment. Neurectomy has a 20% risk of stump nerve formation which causes a return of neuroma symptoms.