We all deal with patients who present with Morton’s Neuroma symptoms. These 10 treatment options are in my office handout to the patient to get treatment moving. Of course, some will need surgery, but that recommendation can be months to years away (for many reasons). We have to start somewhere, and this list gives the patient solid information and a starting point to good questions (like “What is neural flossing, and how do I do it?) I usually add a metatarsal pad to their shoe insert, or previously made orthoses, and tell them to experiment with the best placement in terms of pain relief. I only cut off about a third of the pad’s backing, so they can move it around easier. If they always seem worse with icing, reduce the timing to 5 minutes twice daily especially after they have irritated their symptoms. I start them on Neuro-Eze or Neuro One that they get on Amazon first. I tell them to chart their symptom flare, were they walking, sitting, standing or lying, and I tell them that we may have to look at alignment and back problems (I always have a back specialist to see when needed for co-treatment).
The top 10 initial treatment options for Morton’s neuroma are:
- Attempt to off-weight the painful area with a metatarsal pad.
- Ice pack the bottom of your foot for 10 minutes, 2-3 times per day.
- Begin using a topical nerve medication like Neuro-Eze or compounding medication (that you will need an Rx for).
- Do neural flossing three times per day. (More insight here)
- Avoid barefoot walking until the symptoms begin to resolve (I personally love Oofos sandals around the house).
- Experiment with shoe gear that seems the most comfortable (not necessarily what you think).
- Look into other causes of nerve pain like sciatica or tarsal tunnel.
- Do what you can to create a pain-free environment (0-2 pain levels).
- If the metatarsal pads do not help, see if you can get fitted for orthotics and experiment with Budin splints, digital taping, and toe separators.
- If there is any swelling, do contrast bathing each evening.
Morton’s neuroma denotes a swollen, inflamed, painful nerve classically between the third and fourth metatarsals, radiating into the third and fourth toes. It can also be between the second and third metatarsals, or between both the third/fourth and second/third, just to make diagnosis more difficult. The nerve symptoms created can be more like numbness, tingling, buzzing, burning, sock-rolled-up sensation, etc. on one side on the spectrum, to sharp, radiating, and electrical pain at a level 8 to 10 on the pain scale. One of my unfortunate patients described it as lava flowing in her foot!!
Next week we will continue our discussion with the standard components of a great orthosis for Morton’s Neuroma.
