Morton neuroma

Diagnosis

During the exam, your healthcare professional will ask questions about your symptoms, general health, medical history and typical activities. Your health professional also will examine your foot by:

• Applying pressure at points along the ball of your foot to locate the site of pain.
• Squeezing the ball of the foot and feeling for a click between metatarsal bones.
• Testing the range of motion of the toes.
• Looking for other signs of irregularity in the foot that may contribute to pain.

Imaging tests

Some imaging tests may be used if your healthcare professional would like to confirm a diagnosis of Morton neuroma or rule out another cause of pain. These may include:

• X-rays. An X-ray of your foot while standing can reveal a bone fracture or other bone irregularity in the foot.
• Ultrasound. An ultrasound may be used to confirm a diagnosis of Morton neuroma or spot irregularities in soft tissues in joints.
• Magnetic resonance imaging (MRI). An MRI may also be used to view soft tissues. This imaging may be used to rule out other conditions or when symptoms are not typical.

Treatment

The first line of treatment is usually to avoid activities that worsen symptoms and change footwear.

Shoes

Changes to shoes that can improve symptoms include the following:

• Avoid high-heeled shoes.
• Wear shoes with wide toe boxes that don't crowd the balls of the feet.
• Use a ready-made or custom-made shoe insert with padding that cushions and supports the forefoot.

Corticosteroids

A corticosteroid may be injected into the nerve to treat pain. The injection is usually guided with an ultrasound device. The corticosteroid may be combined with a local anesthetic that temporarily numbs the area. This is usually a single injection.

Surgery

If other treatments don't work, your healthcare professional may recommend surgery. Surgical removal of the damaged, enlarged portion of the nerve is called a neurectomy.

This is the most common procedure for treating Morton neuroma. The surgery is usually successful, but there may be permanent numbness in the affected toes.

Other procedures that haven't been studied extensively may be used. These include procedures that:

• Disable the affected nerve without removing it.
• Create more space for the nerve in the forefoot by cutting tissues that connect bones.

Lifestyle and home remedies

To help relieve the pain of Morton neuroma and allow the nerve to heal, consider the following self-care tips:

• Take anti-inflammatory medicines. Nonprescription nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), may relieve pain.
• Try ice massage. Regular ice massage may help reduce pain. Freeze a water-filled paper or foam cup and roll the cold cup over the painful site.
• Change your footwear. Have your feet measured at a shoe store to make sure you are buying shoes of the correct size and width. Avoid high heels or tight shoes. Choose shoes with wide toe boxes.
• Take a break. For a few weeks, reduce activities such as running, jumping, climbing or dancing that subject the balls of your feet to high impact.

Preparing for your appointment

You'll likely see your primary healthcare professional first. You may be referred to a doctor or surgeon who specializes in foot conditions.

What you can do

Before your appointment, you may want to write a list of answers to the following questions:

• When did your symptoms begin?
• Did your symptoms begin gradually or suddenly?
• What type of footwear do you wear for work and recreation?
• Do you participate in sports? If so, what types in particular?
• What medicines and supplements do you take regularly?

What to expect from your doctor

Your healthcare professional may ask some of the following questions:

• How would you describe the pain?
• Do you feel any tingling or numbness in your foot or toes?
• Is the pain worse when wearing certain shoes?
• Do certain activities worsen the pain?
• Does anything lessen the pain? What home remedies have you tried?
• Are you experiencing any other pain in your body?