Morton's Neuroma

Morton’s Neuroma was first described in 1876 as perineural fibrosis – degeneration of the common plantar digital nerves. It is most commonly observed in the 3rd intermetatarsal space of the foot. Typical is the neuropathic type of pain due to chronic nerve irritation. The condition is more common in women, 20 to 50 years old, with slim legs who usually wear tight and high heels.

The patients describe a burning sensation on the plantar surface of the foot, usually in the 3rd intermetatarsal space, finger hypoaesthesia, symptoms exacerbated by the use of high-heeled footwear.

Diagnosis is based on medical history and detailed clinical examination. In the differential diagnosis, the treating physician should consider metatarsalgia (fall of metatarsal arch), fatigue of the corresponding metatarsal, osteoarthritis and osteonecrosis of the metatarsal bone. In some cases, further examinations, such as X-rays or even magnetic resonance imaging, may be necessary to complete the examination.

Treatment can be conservative or even surgical. Conservative therapy includes cryotherapy, ultrasound, stretching exercises and use of orthopedic insoles to support the metatarsal arch. Topical cortisone infusion is indicated if the above treatment methods fail. If the patient continues to suffer then surgical treatment by removing Morton’s neuroma provides the ultimate solution to the problem.