A Morton’s neuroma is a thickening of one of the small nerves that run between the toes (most often between the third and fourth toes). It causes burning pain, tingling and numbness in the ball of the foot, often described as walking on a pebble or having a sock bunched up underfoot.

Morton’s neuroma excision is an operation to remove the affected portion of nerve (or, in some cases, to release the tight ligament compressing it). It is reserved for neuromas that remain painful despite non-surgical treatment, and provides reliable, lasting relief for most patients.

• Wide, low-heeled footwear with a cushioned sole — the most important first measure
• Metatarsal pads and orthotics to offload the affected space
• A corticosteroid injection, which can settle symptoms for a period

Surgery is considered when these measures have not given adequate, lasting relief.

Neuroma Excision

Through a small incision, usually on the top of the foot (a dorsal approach), the affected nerve is identified and the thickened segment removed. The dorsal approach allows early walking and avoids a scar on the sole of the foot. The nerve is removed which causes numbness to the inside of two adjacent toes, but it is well tolerated and stops the clicking and sharp pains.

Nerve Decompression (an Alternative)

In selected cases, releasing the tight ligament that compresses the nerve (decompression), rather than removing the nerve, can relieve symptoms while preserving some sensation. Mr Welck will discuss which approach is most appropriate for you.

Mr Matthew Welck is a Consultant Orthopaedic Foot & Ankle Surgeon at the Royal National Orthopaedic Hospital (RNOH), Stanmore — the largest specialist orthopaedic hospital in the UK — and an Honorary Associate Clinical Professor at University College London (UCL). He is widely regarded as one of the best and most experienced foot and ankle surgeons in London and North London, with a national and international reputation in complex foot and ankle reconstruction, total ankle replacement, and sports injuries of the foot and ankle.

Patients choosing Mr Welck benefit from:

• Subspecialist fellowship training in foot and ankle surgery, including Morton’s neuroma and forefoot surgery
• A high-volume practice in Morton’s neuroma and forefoot surgery as both an NHS consultant at the RNOH and in private practice across London and North London
• Access to advanced imaging including weight-bearing X-ray, weight-bearing CT, MRI and ultrasound
• Treatment of NHS and private patients across London and North London, including RNOH Stanmore, Spire Bushey, HCA The Princess Grace and The Wellington Hospital Elstree
• A multidisciplinary team approach, working alongside leading physiotherapists and orthotists for rehabilitation and return to sport
• Evidence-based, patient-centred care — surgical decisions are only made after a full discussion of the alternatives, benefits, risks and realistic outcomes

If you have persistent burning forefoot pain or numbness that has not responded to footwear changes, orthotics or injections, an expert review will confirm the diagnosis and set out whether surgery can help. Mr Welck is a leading London and North London specialist in Morton’s neuroma and forefoot surgery.

To arrange a consultation with Mr Matthew Welck:

• Telephone: 07547 395 270
• Email / contact form: matthewwelck.com/contact
• NHS referrals: via your GP to RNOH Stanmore
• Private appointments: London and North London locations

This page is for information only. It does not replace personalised medical advice. Always consult a qualified medical professional before making decisions about your diagnosis or treatment.