by Last updated on February 8th, 2024 at 04:29 pm
Everyone responds differently to the treatment of Morton’s neuroma, and each clinician treats their patients more often than not individually. With that said, the treatment options discussed below are just a guide. If you are suffering from Morton’s neuroma, it is appropriate to see your healthcare provider. Read on to find out more!
Rest
When treating Morton’s neuroma, the first thing is to rest the feet with the neuroma. Taking the weight of the feet reduces the pain and prevents further irritation of the plantar nerve. Rest isn’t always a luxury many can afford. Still, to increase clinical outcomes, staying off the feet as much as possible is essential. Elevating the feet may also help to reduce inflammation.
Ice Pack
Some people find the use of an ice pack over the area helpful. It helps to reduce the swelling caused by the inflammation, thereby easing pain. Apply an ice pack or a frozen bag of peas to the area twice daily for 15-20 minutes.
Use Anti-inflammatory Medications
Morton’s neuroma causes the sheath around the plantar nerve between the toes to become inflamed. Anti-inflammatory with rest should see an improvement in the condition. Ibuprophen and naproxen should be available at your local pharmacy. Please follow the instruction on the label as an anti-inflammatory like ibuprofen should not be used for extended periods as it can irritate the stomach.
Also, try not to use it for more than three days. You can also use the gel version if the tablet is not well tolerated. Please, remember to consult your healthcare provider before taking any medications, especially if you have underlying medical conditions or already taking medications.
Avoid High Heels
One leading contributing factor to Morton’s neuroma is pressure on the plantar aspect of the forefoot. This pressure can be transmitted to the nerve, irritating it. For this reason, shoes with high heels should be avoided as they increase forefoot plantar pressure.
Wear Roomy Shoes
Shoes with a wide and deep toe box allow the toes to splay, taking pressure off the neuroma. Try to avoid footwear with a thin sole/bottom. Also, ensure the footwear has a fastener to stop your foot from clawing for grip. Additionally, footwear with a rocker bottom or toe spring helps to take pressure off the forefoot during gait, so use a shoe with that feature.
Use toe Spacers
Toe spacers help to spread the toes. Doing this takes the pressure off the neuroma. Correct Toes, toe spacers have been reportedly shown to be clinically effective in relieving the stress on the neuroma. The device can take up space in your shoes; as such, you may require a bigger fit shoe.
The device can be expensive, so if you are interested, look for alternatives. You could also look into the use of gel toe spacers. There are loads on the market you can try.
Reduce BMI
Morton’s neuroma is associated with weight gain. Some people get easily offended or embarrassed discussing their weight. Nevertheless, if your body max index (BMI) exceeds the recommended level, you should try to reduce it. Doing this will increase clinical outcomes.
Metatarsal Pad or Dome
Studies have shown that using a metatarsal pad or dome on the plantar aspect of the forefoot can help to splay the toes and is clinically effective for Morton’s neuroma. The science behind it seems counterintuitive, as the dome raises the forefoot slightly, adding pressure. However, the dome shape allows the toes to splay while easing the pressure under the forefoot, reducing stress on the neuroma. Please consult a podiatrist before using it to ensure it’s appropriate for you.
Orthotics
There are different types of orthotics to treat Morton’s neuroma, depending on what is causing it. Most incorporate a dome pad in the middle, arch support, or heel adjustment, to name a few. Orthotics can be uncomfortable initially, but they should be worn in slowly. It is wise to see a podiatrist to help in this regard.
Injection Therapy
A corticosteroid injection can help to reduce pain and inflammation. However, some practitioners are judicious with its use, while others prefer not to use it. The long-term use of corticosteroids can compromise the integrity of surrounding tissue; therefore, many clinicians limit its use to three treatments.
Some practitioners prefer alcohol (Alcohol sclerosing injection) to kill the part of the nerve causing the pain. A solution composed of 20% – 40% alcohol is typically used. It’s unclear how long the remission of symptoms lasts, but reports suggest it can last for years.
Cryosurgery/Therapy
This procedure involves placing a probe in the foot at the site of the neuroma. A freezing agent is then used to kill the part of the nerve causing the problem. Cryosurgery is a minimally invasive procedure, typically done with ultrasound guidance, and the outcome can be excellent.
Radiofrequency Ablation
The radiofrequency ablation procedure involves placing a probe in the base of the toe next to the neuroma. An electric signal (radiofrequency heat) is sent through the probe, destroying the nerve. A corticosteroid injection is usually given after the procedure to reduce inflammation. Patients are discharged when comfortable and advised to avoid walking for at least two days.
Surgery
If all of the above fails, then a last resort is surgery. The site of the neuroma is entered from above or below the feet. The space surrounding the neuroma is widened, or the affected part of the nerve is removed. After the surgery, some people experience numbness at the site of the neuroma. Still, satisfaction is high among patients who have had the procedure. A podiatric or orthopaedic surgeon typically carries out the surgery.
FAQs and Answers
1. What are the symptoms of Morton’s neuroma?
Symptoms of Morton’s neuroma include pain, burning, and tingling in the ball of the foot and numbness in the toes. These symptoms may be worse when walking or wearing tight shoes
2. How can I prevent Morton’s neuroma?
Wear shoes with a wide toe box and low heels, avoid high-impact activities and take regular breaks if you stand for long periods.
3. Can Morton’s neuroma be cured?
It can be treated successfully with non-surgical methods. Still, surgery may be necessary in some cases to completely resolve the condition. Even after successful treatment, there is a risk that the neuroma could return, so it is vital to take steps to prevent it from recurring.
4. How is Morton’s neuroma diagnosed?
Morton’s neuroma is diagnosed through a physical examination of the foot and a review of the patient’s medical history. Other diagnostic tests, such as an ultrasound, X-ray or MRI, may also be used to rule out and confirm the diagnosis.
5. Is it normal to feel pain in my toes after Morton’s neuroma treatment?
Pain in the toes after treatment for Morton’s neuroma is not uncommon. As a result, a small number of patients get persistent pain after surgery, and in some cases, the neuroma return.
6. Can I wear high heels if I have Morton’s neuroma?
It is generally recommended to avoid wearing high heels if you have Morton’s neuroma, as the added pressure on the ball of the foot can exacerbate the condition. Instead, opt for shoes with a lower heel profile and a wide toe box to help relieve pressure on the affected area.
7. Can I exercise if I have Morton’s neuroma?
It is essential to avoid high-impact activities that put added pressure on the ball of the foot, such as running or jumping, for instance. With that in mind, exercise such as swimming or cycling, may be more suitable.
8. Can Morton’s neuroma cause permanent nerve damage?
Morton’s neuroma does not typically cause permanent nerve damage. However, if left untreated, the condition can lead to chronic pain and permanent damage, possibly impairing associated toe function. It is important to seek treatment for Morton’s neuroma to prevent it from getting worse.
Final thoughts
In conclusion, Morton’s neuroma is a painful condition affecting the ball of the foot. It can cause pain, burning, and tingling in the toes. While non-surgical treatment options, such as rest, ice, and over-the-counter pain medication, can be effective in mild cases, more severe cases may require a corticosteroid injection or surgery. It is essential to wear shoes with a wide toe box and low heels and avoid high-impact activities to help prevent it. If you are experiencing symptoms of Morton’s neuroma, you should consult a healthcare provider for proper diagnosis and treatment.
