- 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.
- Diagnostics are not recommended in primary care.
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.
- Diagnostic uncertainty.
- Poor foot posture (e.g flat foot).
- Failure of conservative measures.