Forefoot pain/Morton's neuroma
What is it?
Morton’s neuroma is a thickening in and around the nerve between the first and second, or second and third, toe. If the swelling becomes large, the nerve can no longer fit between the toes and, while walking, can be pushed upwards, which causes pain and other neurological symptoms. Morton’s neuroma is a common cause of forefoot pain.
Why does it occur?
Often there is no obvious underlying cause, but it can be secondary to other forefoot deformities or repetitive sports activities.
What are the symptoms?
Symptoms can include pain and numbness in one part of the ball of the foot, which occasionally spreads to the toes. Any pain can be burning or stabbing in nature, and sometimes affects your ability to walk comfortably. Some patients with this condition describe it feeling as there is a stone or marble under their foot.
How is it diagnosed?
Your consultant will take a medical history, and carefully examine your foot, as it is important to rule out any other causes of forefoot pain. Occasionally, in order to help confirm a diagnosis, ultrasound scans to identify a swelling in the nerve may be required.
How is it treated?
Wearing wider footwear and shoes with cushioned soles may well improve symptoms sufficiently to avoid further intervention. The next step would normally be a steroid injection and ultrasound guidance of a local anaesthetic. In around half of those with this condition, this treatment will resolve any symptoms.
Surgery often involves removing the affected nerve in the ball of the foot. An incision is made on the top of the foot and the nerve is carefully removed. In the majority of patients, this normally resolves any symptoms.
Morton's neuroma surgery
The One Orthopaedics team specialists
Consultant Orthopaedic Foot and Ankle Surgeon FRCS (Tr & Orth)