Morton’s Neuroma Treatment Canberra
A burning pain under the ball of the foot is one of the more common signs of Morton’s neuroma. You might also notice tingling or numbness in the third and fourth toes, or the odd feeling that there is a pebble or a bunched-up sock inside your shoe.
This does not imply that a neuroma is the issue, though. There are a number of other causes for forefoot pain. At Capital Podiatry in Tuggeranong, Canberra, we identify what it is that is causing it. Following our diagnosis, an appropriate treatment plan can be provided. Most patients improve with non surgical treatment, so there is usually no reason to jump straight to surgery.
What Morton’s Neuroma Feels Like
The pain is usually felt between the metatarsal heads, specifically the area between the third and fourth toes. The second and third toes may also be affected but this is less common. Instead of feeling a dull pain, people normally experience a sharp burning pain, especially after prolonged periods of standing and walking.
This condition tends to be exacerbated by tight shoes. If you take off your shoe and rub your forefoot a little, the discomfort may subside fairly quickly. This reaction is helpful in providing a diagnosis, as it can help distinguish a neuroma from pain coming from a joint.
Alongside the pain, many people notice a tingling sensation or numbness in the affected toes. Symptoms come and go at first. Some people put up with them for a few years before the flare-ups become frequent enough to do something about.
What Causes a Neuroma to Develop
Morton’s neuroma develops when repeated nerve compression and irritation cause the nerve tissue around the interdigital nerve to thicken. This small digital nerve runs between the metatarsal heads towards the toes. As it becomes thicker, there is less space for the nerve, so the irritation can continue. Despite the name, a neuroma is not a tumour.
One of the major contributors to this condition is footwear. Wearing high heels places more pressure on the forefoot, and wearing tight shoes with a narrow toe box causes the metatarsal heads to be pushed closer to each other. That leaves less room for the nerve with every step.
Sometimes, it’s not about the shoes. Irritation may be caused by repetitive stress from running and playing sports on a court, and the shape of your foot can change where the load falls. Flat feet, high arches, bunions and other foot deformities can all put extra pressure through one part of the forefoot, leaving the nerve in that area more likely to become irritated.
How Morton’s Neuroma Is Diagnosed
We start with your medical history and a few questions about the problem itself. Where is the pain coming from? When do you notice it most? We also want to know about the shoes you normally wear and how much time you spend on your feet.
The next step is performing a physical examination of the forefoot. This involves pressing the metatarsal heads, as well as squeezing the foot on each side. The appearance of pain or a tingling sensation when doing this gives us enough information to have Morton’s neuroma diagnosed with reasonable confidence.
The examination also helps pinpoint any other potential conditions that could be causing pain in the same place. For example, a stress fracture in a metatarsal bone may present in the same way, as might a case of inflammation involving the joint, bursitis between the toes or bony growths.
If we think biomechanical issues are contributing to the condition, we will study the way your foot functions while walking and what areas of the forefoot receive the most pressure. This will tell us why the nerve keeps being irritated to begin with.
Imaging is not always required. Ultrasound can help when we need to prove or measure the size of the neuroma, but often our examination alone provides us with the information we need.
Morton’s Neuroma Treatment Options at Capital Podiatry
Nearly all neuroma treatment aims to relieve pressure on the nerve and settle the inflammation around it. Conservative treatment works for most people, and it works best when started before the nerve has been irritated for months. We usually combine two or more of the approaches below rather than relying on one.
Footwear Changes
If your shoes are part of the cause, changing them is the first thing to do and sometimes the only thing needed. We look for a wide, deep toe box and a sole firm enough that the forefoot does not bend excessively. A low heel is the other requirement, so weight is not tipped forward onto the metatarsal heads. Our footwear advice is specific to your foot shape and the shoes you actually need for work or sport, and we will tell you plainly if a favourite pair is making things worse. For some people, footwear modifications alone bring significant improvement within a few weeks.
Orthotics and Metatarsal Domes
The single most useful device for a neuroma is a metatarsal dome, a small pad that sits just behind the metatarsal heads and spreads them slightly apart so the nerve has more room. It can often be fitted to an existing insole. Where flat feet, high arches, a bunion or other biomechanical issues are loading the forefoot, we build custom orthotics with the dome positioned for your foot. Appropriate orthotic therapy redistributes pressure away from the nerve on every step, so it keeps working long after the appointment.
Foot Mobilisation, Dry Needling and Other In-Clinic Therapies
Stiff joints in the midfoot and forefoot can push extra load onto the metatarsal heads. Foot mobilisation therapy uses hands-on techniques to restore movement in those joints so the forefoot spreads naturally under load. Dry needling and acupuncture with moxa is another option we use for pain relief, particularly when tight muscles in the foot or calf are adding to the pressure. Depending on your assessment, shockwave therapy or MLS laser therapy may be added to help reduce inflammation around the nerve. We will also show you strengthening work for the small muscles of the foot to do at home.
When Injections or Surgery Come Into the Picture
If symptoms have not eased after several weeks of well-applied conservative treatment, corticosteroid injections can reduce inflammation around the nerve. These are arranged through your GP or a specialist rather than in our clinic, and we will tell you when we think that step is warranted. Over-the-counter anti-inflammatory medications and anti-inflammatory gels can help you manage pain in the short term, but they do not address the pressure causing it.
Surgery to remove or release the nerve is reserved for severe cases where everything else has failed, and it usually leaves some permanent numbness between the affected toes. That is a trade-off worth avoiding where it can be, so we adjust conservative treatment before recommending a referral.
Who to See and What It Costs
A podiatrist is the right first call for a suspected neuroma. We diagnose and treat it in the same clinic, orthotics included, and you do not need a referral to book. See your GP first if the pain came on suddenly after an injury, or if you have diabetes and any numbness in the foot, since nerve symptoms need a wider check in that situation. A foot and ankle surgeon becomes involved only if conservative treatment has run its course.
An initial consult covering the foot and leg is $250 with a podiatrist and $270 with our principal podiatrist. It includes an orthotics assessment if you need one.
Book an Appointment or Visit Our Clinic
Our clinic is at Shop 9 Homeworld, corner of Anketell Street and Reed Street North, Greenway, in the Tuggeranong town centre. There are two hours of free parking in the Homeworld carpark. We are open Monday to Friday, 9:00am to 5:00pm.
Book online to see available times, or call us on (02) 6293 3300 if the appointment you need is not listed on the booking form.
Frequently Asked Questions
Can Morton’s Neuroma Go Away on Its Own?
Early on, symptoms sometimes settle once the shoes causing the pressure are changed. After the nerve has thickened, it rarely shrinks back without treatment, and flare-ups usually become more frequent. The longer the nerve is compressed, the harder it is to settle, so an assessment in the first few weeks gives you the best chance of avoiding injections or surgery.
What Shoes Should I Wear With a Morton’s Neuroma?
Choose a shoe with a wide toe box and a low heel. The sole should not fold easily under the ball of the foot. Lace-up runners and wide-fit walking shoes usually work well. Avoid high heels, narrow dress shoes, pointed-toe boots and thin-soled flats while the nerve is irritated. Bring your everyday shoes to your appointment and we will check them.
Do I Need a Scan to Have Morton’s Neuroma Diagnosed?
Usually not. A history and a physical examination of the forefoot identify most neuromas. We may suggest an ultrasound if the picture is unclear, or if symptoms are not responding to treatment the way we would expect.
How Long Does Morton’s Neuroma Treatment Take?
Most people notice improvement within a few weeks of changing footwear and using a metatarsal dome or orthotic, with further gains over the following months as the inflammation settles. Longstanding neuromas take longer, and some need an injection to get moving. We review progress at each visit and adjust the plan rather than waiting to see.
TAKE THE FIRST STEP
Every journey starts with a single step, there’s no need to suffer any longer.
Make an appointment with our experienced podiatrists today.
Get in touch to book an initial Consult for Foot, Leg & Orthotics