Morton’s neuroma is inflammation, thickening, or enlargement of the medial plantar nerve that resides between your metatarsal bones. This thickening most often develops between the third and fourth, or second and third toes.
This often feels as though a lump is on the ball of your foot, or like you have a small pebble in your shoe. Other symptoms include tingling and numbness or a burning sensation in the ball of your foot.
There are many factors and lifestyle habits that can lead to Morton’s Neuroma. Women are 8 times more likely than men to suffer from Morton’s Neuroma*. This is due to high heels that place extreme pressure on the ball of the foot. However, anyone who consistently wears ill-fitting or pointy shoes are at a higher risk for Morton’s neuroma—as well as a multitude of other foot and ankle concerns.
The best treatment for Morton’s neuroma, before considering surgery, include:
Morton’s neuroma surgery should only be considered after exploring all non-surgical options. Surgery is effective in 75 to 85 percent of all cases. The most common surgery (a neurectomy) includes making a small incision in the top of the foot, and then removing the damaged nerve tissue.
Another surgical option is the plantar approach, where the incision is made through the ball of the foot. This option allows the inflamed nerve to be preserved, and for only a small amount of the effected tissue to be dissected. However, the recovery time for this approach is significantly longer.
Post-op recovery will vary, depending on the incision performed and the extent of the dissected nerve and tissue. In a standard neurectomy, recovery time is between 2 and 3 weeks. The incision must be kept clean and dry. The foot must be kept elevated above the heart, and overall physical activity (even walking) must be kept to a minimum. You may be provided with a post-op shoe to minimize pressure. Scar tissue may develop at the incision site, which may lead to long-term numbness or tingling; however, far less severe than your original discomfort.
With a plantar approach surgery, recovery time will take between 4 and 6 months. This is because the incision site is at the bottom of your foot, as opposed to the top of your foot. While recovery time may be longer, your odds of recovering full range of motion are increased.
Regardless of the surgery selected, you will have to wear supportive shoes in the weeks and months following your surgery. Full recovery for walking, standing, and physical activity takes an average of 1 to 6 weeks and varies, depending on your lifestyle habits. For example, if you stand all day at work, it will take far longer to work your way up to a full day than if you are seated at a desk most of the day.
*Climent, J. M., Mondéjar-Gómez, F., Rodríguez-Ruiz, C., Díaz-Llopis, I., Gómez-Gallego, D., & Martín-Medina, P. (2013). Treatment of Morton Neuroma with Botulinum Toxin A: A Pilot Study. Clinical drug investigation, 33(7), 497-503.
Any time you experience pain, inflammation, numbness, or tingling in your foot, you should seek the expertise of a foot and ankle specialist. Even the slightest change can be an indicator that a larger problem has developed. Early diagnosis and treatment can mean the difference between a minor concern and an ongoing foot or ankle condition.