Will I Need Surgery for My Morton’s Neuroma?

When you have persistent pain in your foot, I know how many of your brains start to work. You’re wondering if you will ever feel better. Or if you’ll need surgery to make a full recovery. Let’s take a look at one condition, Morton’s Neuroma, where surgery is often recommended. We’ll explore the symptoms of the condition and what I can do to help you feel better well before we start talking about surgery.

What is Morton’s Neuroma? 

Morton’s neuroma is an enlarged nerve in the ball of your foot. Typically, this nerve is located between your third and fourth toes. When the nerve, which brings sensation to your toes, becomes enlarged, it rubs up against or becomes trapped by the bones and tissues in the middle of your foot. Once you reach this point, you may experience numbness, burning or tingling in your toes or forefoot. You may also experience sharp pain or even swelling in the area.

Unfortunately, we don’t really know what causes Morton’s neuroma. What we do know, however, are some things that can contribute to or worsen this nerve problem. Factors that contribute to Morton’s neuroma include:

  1. Wearing narrow shoes, which squeeze your toes
  2. Rocking high-heels, since they put extra pressure on the ball of your foot
  3. Inflammation, illness or trauma to your forefoot.
  4. Your body’s biomechanical issues—both flat feet or high arches—can create instability around the joints of your toes, possibly contributing to the nerve’s irritation.
  5. Having bunions or hammer toes
  6. Playing high-impact sports, such as basketball or running 

Diagnosing and Treating Morton’s Neuroma

Often, your podiatrist can diagnose a neuroma with a simple physical exam. Most people who have Morton’s neuroma present with tenderness in their forefoot; sometimes I can even feel a small mass in the area.

Your reported symptoms can also help us reach a diagnosis: aside from numbness or tingling, you may feel like there’s a clicking sensation between your toes. If, however, we can’t immediately diagnose a neuroma from your exam, I may also order an ultra-sound to confirm the diagnosis. You may need an X-ray to rule out other conditions

Once we know you’ve got a neuroma, it’s time to explore your treatment options. And those will depend on how severe your symptoms may be. For many people with neuromas, relief can be found simply by switching to flat-soled, supportive shoes with room for your toes and plenty of padding beneath the ball of your foot. A proper shoe can take pressure off your neuroma, providing you with comfort and relief.

If different shoes alone aren’t working, we can get you fitted for custom orthotic inserts with metatarsal support. You may also find relief from anti-inflammatory medications or injections. But you can also try shockwave therapy, since this form of treatment has proven to be very effective at treating the pain of Morton's Neuroma.

When is Surgery Recommended for Morton’s Neuroma?

Now that we’ve helped you understand this nerve problem, and walked you through less invasive treatment options, it’s time to answer our initial question. Will you need surgery to relieve the pain of Morton’s neuroma?

For many people, the answer will—thankfully—be no. Conservative treatments are typically very effective at relieving your Morton’s neuroma pain. If, however, you’ve tried less invasive treatments and your pain persists, surgery may be indicated for Morton’s neuroma.

Dr. Andrew Schneider
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Dr. Andrew Schneider is a podiatrist and foot surgeon at Tanglewood Foot Specialists in Houston, TX.