A  "Morton's neuroma" is an entrapment of a small nerve in the foot. Symptoms may include pain, numbness, and/or burning sensations in the ball of the foot which may radiate out into the toes or up the leg. Pain occurs while standing or walking and can range from mild to severe. It may be worsened by wearing tight-fitting or high heeled shoegear and may be relieved by removing the shoes and massaging the affected area.

It is usually related to instability in the mechanical function of the foot. This instability results in the nerve being compressed against or pulled across a rigid, unyielding ligament called the transverse intermetatarsal ligament (TIML). It is this repetitive microtrauma to the nerve that causes it to become inflamed and eventually entrapped in scar tissue. If allowed to persist over long periods of time, this process and its resulting symptoms may become irreversible causing considerable disability.

Once the symptoms are recognized, proper medical care should be obtained as soon as possible to minimize the possibility of permanent nerve damage. If surgery (decompression) has been determined to be necessary, this potentially debilitating condition requires the skills of a specialized practitioner to properly diagnose, counsel, and successfully treat the patient in order to restore normal foot function. The goal of treatment is to allow the individual to maintain or return to a normal lifestyle. This condition is best treated by peripheral nerve decompression, and a minimally invasive endoscopic technique is available called the EDIN (endoscopic decompression of intermetatarsal nerve). This condition should not be primarily treated with freezing or sclerosing injections!!!

A number of conservative, non-surgical treatment options may be utilized. Oral anti-inflammatory medications and/or injections may alleviate pain. However, the cause of the problem must be addressed. Biomechanical control of the foot and the elimination of microtrauma on the nerve is of paramount importance in order to insure lasting relief of symptoms. If conservative treatment fails to relieve the symptoms, then surgery may be required.

Warning! Cortisone Injections may cause plantar plate rupture, which can result in the formation of a hammertoe, as seen in the photo of the diagnostic ultrasound and clinical photo. A steroid (cortisone) injection gives only temporary relief and may mask the pain leading to further nerve damage. However, diagnostic injections of a local anesthetic may be very beneficial for proper diagnosis, and are safe.

Endoscopic decompression of intermetatarsal nerve is a new surgical technique developed by Dr. Barrett, in 1994 to permanently correct neuroma pain in a less traumatic manner.

This technique allows for a quicker recovery and a faster return to normal activity than traditional surgical techniques. Specially designed instrumentation is utilized that allows the surgeon to directly visualize the foot structures on a video screen through two small, less than ¼ inch incisions on the foot. The procedure is performed in an outpatient setting. Most patients can bear weight immediately after surgery and return to tennis shoes the day after surgery. Everyone heals differently. Factors such as age, weight, circulation, and occupation contribute to healing times.