Mortons Neuroma

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Patient Information

GP Information

Background Information

  • A Mortons neuroma refers to compression of an interdigital nerve commonly between the 3rd and 4th toe.
  • Patients typically complain of shooting pain or altered sensation in the web space or toes.
  • Pain is worse on weight bearing or wearing narrow toe box shoes (high heels).
  • Examination may reveal a palpable neuroma in the web space or a positive Mulders Click.

Investigation Guidelines

  • Diagnostics are not recommended in primary care.

Management Recommendations

A mortons neuroma is sometimes a result of forefoot overload and is not always the cause of forefoot pain when found on a scan. The majority of patients will require referral. Initial conservative measures include.

  • Patient education.
  • Shoe wear advice.
  • OTC orthotics if flat footed.

Referral Indications;

  • Diagnostic uncertainty.
  • Poor foot posture (e.g flat foot).
  • Paraesthesia.
  • Failure of conservative measures.
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