Morton's neuralgia

Morton's neuralgia

Morton's neuralgia, also Morton's metatarsalgia or Morton’s syndrome, is a painful disorder in the foot area characterised by bulb-shaped swelling (a “neuroma”) between the heads of the distal metatarsal bones. It mostly occurs between toe III and IV, and more rarely between II and III.

Morton’s neurinoma is responsible for “toxic”, shooting or electric pains in the forefoot area. Some patients need to remove their shoes immediately to massage the sole of their foot and relieve the pain. A hyposensitivity in the area of the pain is often reported. If pains and/or hyposensitivity occur in the space between other toes, there is strong reason to suspect a peripheral polyneuropathy (e.g. in diabetes mellitus). In every case, a neurological analysis is then advisable.

Treatment
Some patients respond well to a prescribed insert with a retrocapital support to relieve the sensitive nerves at the points where they join, particularly if this is accompanied by a flattening of the transverse arch. It is also possible for the pain area to be infiltrated by a local anaesthetic with some added cortisone. If these steps are not sufficient, a surgical removal of the thickened nerves should be discussed with the patient. The patient should be informed of the general risks and the residual complaints in the form of phantom pains, which can in some cases be very unpleasant.