Morton’s Neuroma Surgery – severe foot pain option

Morton’ neuroma causes pain in the 3-4th metatarsal head areas with numbness in the corresponding 3rd and 4th toes. The pain, including burning pains in area can become extreme. Surgical removal works well 51-85% of time.

Foot Ankle Spec. 2011 Dec 1. [Epub ahead of print]
Long-Term Results of Neurectomy in the Treatment of Morton’s Neuroma: More Than 10 Years’ Follow-up.
Lee KT, Kim JB, Young KW, Park YU, Kim JS, Jegal H. abstract here

  • tenderness in the 3-4th  intermetatarsal space.
  • when squeezing pressure is applied to the intermetatarsal space, a painful and palpable clicking sensation is induced (Mulder’s sign).
  • (if you are good, you can feel an enlargement where neuroma is)
  • Ovoid mass on ultrasound
  • failed NSAID’s, metatarsal pads, shoe modification, and steroid injection for 6 months
  • Pain improved from 8.6 to 2.4/10
  • There have been 8 studies – followup 4-10 years – good results in 51- 85% of cases

(present study, of 13 cases, got 10 years satisfaction of 61%)

  • Side effect included some continued pain and unsettling numbness in 3rd and 4th toes.

Comment – Steroid or alcohol injections are alternatives but the former could thin fat pad under foot, and cause issues there, if injected too deep

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