Foot & Ankle

Morton's Neuroma

Morton’s Neuroma is a common foot condition caused by the thickening of the tissue around one of the nerves leading to the toes, typically between the third and fourth toes. This nerve compression causes discomfort, pain, and swelling, which can significantly limit daily activities. Women are eight times more likely to develop Morton’s Neuroma than men, and it typically affects individuals between the ages of 30 and 60, though it can occur outside of this age range.

What is Morton’s Neuroma?

Morton’s Neuroma occurs when the nerve tissue between the toes becomes thickened due to compression or irritation, typically in the web space between the third and fourth toes. This thickening leads to inflammation and pain in the forefoot. The condition is most often associated with activities that put pressure on the forefoot, such as running, walking, or wearing tight shoes.


Common Symptoms of Morton’s Neuroma

The symptoms of Morton’s Neuroma vary depending on the severity of the condition. Common symptoms include:

  • Burning or sharp pain in the ball of the foot, often radiating to the toes, especially during weight-bearing activities like running or walking.
  • Sensation of a pebble or marble under the forefoot while walking.
  • Pain typically located between the base of the third and fourth toes.
  • Numbness or tingling in the toes, which may be uncomfortable.
  • Symptoms often worsen with the wearing of high-heeled or narrow shoes, which compress the toes and increase irritation.

Causes of Morton’s Neuroma

Morton’s Neuroma is primarily caused by compression or chronic irritation of the digital plantar nerve, typically caused by:

  • Excessive pressure on the nerve, leading to inflammation and thickening of the nerve tissue.
  • Narrow shoes or high heels that compress the toes, leading to increased pressure in the forefoot.
  • Repetitive stress on the feet from activities such as running or jumping, which increases pressure between the toes.

As the pressure on the nerve increases, the tissue surrounding the nerve begins to swell, causing the abnormal growth of tissue that can make walking or standing uncomfortable.


Diagnosing Morton’s Neuroma

Diagnosis typically involves a medical consultation, where the doctor will take a detailed history and perform a physical examination. During the examination, the doctor may palpate the foot to check for a tender, thickened area between the toes, which is a hallmark of Morton’s Neuroma.

Imaging tests may also be used to rule out other conditions such as stress fractures or arthritis. Common imaging tests include:

  • X-rays to rule out bone-related issues.
  • MRI or ultrasound scans to confirm nerve compression and assess the extent of the injury.


Treatment Options for Morton’s Neuroma

Non-surgical treatments are usually effective for mild to moderate cases of Morton’s Neuroma. If conservative treatment fails, surgery may be considered.


Non-Operative Treatments

  • Rest and Ice Therapy: Resting the foot and applying ice to the affected area can reduce pain and swelling.
  • Footwear Changes: Wearing wide-toe box, low-heeled, and soft-soled shoes to reduce pressure on the toes and minimise discomfort.
  • Orthotics: Custom shoe inserts and metatarsal pads or bars can help by redistributing forces on the forefoot and alleviating pressure on the nerve.
  • Corticosteroid Injections: These can reduce inflammation and swelling around the nerve.
  • Sclerosant Injections (Alcohol Ablation): Used to chemically destroy the fibrous tissue around the nerve to alleviate pain and inflammation.
  • Pain Relievers: Over-the-counter medications like paracetamol or anti-inflammatory drugs can help manage pain and swelling.


Surgical Treatments

If conservative treatments fail, surgery may be considered. The most common surgical treatment for Morton’s Neuroma is:

  • Neurectomy (Nerve Resection): Involves removing the affected nerve or surrounding tissue to relieve the pressure and alleviate symptoms. This surgery is usually performed under local anaesthesia and requires a brief recovery period.


Why Choose Dr. Ryan du Sart for Morton’s Neuroma Treatment?

Dr. Ryan du Sart is a highly experienced orthopaedic surgeon with expertise in diagnosing and treating Morton’s Neuroma. He utilises the latest techniques and treatments to ensure optimal outcomes for his patients. Dr. du Sart’s patient-first approach ensures that each treatment plan is tailored to the individual, helping patients return to a pain-free lifestyle as quickly as possible.


Book a Consultation

If you are experiencing pain or discomfort from Morton’s Neuroma, early intervention is key to preventing the condition from worsening. Contact Dr. Ryan du Sart for a consultation to discuss your treatment options and how he can help you manage your symptoms effectively.

Phone: (08) 9779 9767
Email:  admin@ryandusart.com.au
Locations:
6 Higgins Street, South Bunbury, WA 6230
20 Prince Street, Busselton, WA 6280



References:

  1. Krause, D., & Frick, M. (2018). "Management of Morton’s Neuroma: A Review of Current Treatment Approaches." Journal of Foot and Ankle Surgery, 57(5), 965-970.
  2. Bhatti, S., & DeLee, J. (2020). "Nerve Compression in the Foot: Morton’s Neuroma." Foot and Ankle Clinics, 25(3), 491-499.
  3. Murray, P., & Hochman, L. (2019). "Conservative Treatment of Morton’s Neuroma: A Case Series." Clinical Orthopaedics and Related Research, 457(1), 45-52.