Steroid injections and local anesthetics may provide temporary, but not long-term, symptom relief. Evidence does not support the use of alcohol sclerosing injections for long-term relief.4
Although surgical nerve excision may provide pain relief for Morton’s neuroma, long-term subsequent paresthesiae and shoe limitations are common. In a 2008 study by Womack et that involved 120 patients, 50% had good or excellent outcomes, 10% had fair outcomes, and 40% reported poor outcomes.5
As an alternative treatment, nerve decompression via endoscopy offers a minimally invasive option to address the pathology, while preserving nerve function. In a 2010 study by Barrett et al, 95% of procedures performed in the third intermetatarsal space and 85% of those performed in the second intermetatarsal space had good-to-excellent outcomes for a 92% success rate.6
Data from 1979 study by Gauthier and colleagues that described decompressions performed on 304 neuromas indicated that 83% of outcomes were good, 14% fair, and 3% poor.7
Regardless of the intervention employed, the goal of treatment for Morton’s neuroma is consistent: resolution of pain associated with this common and potentially debilitating condition.
Disclosures: Andrew Rader, DPM, received honoraria from and is a member of the speaker’s bureau for Organogenesis, D.N.E. SEAL External Fixation, and CE Lasers. He also received consulting fees from D.N.E SEAL External Fixation and is a stock shareholder in Fuse Medical.
- American Podiatric Medical Association. Foot health. Available at: http://www.apma.org/learn/FootHealthList.cfm?navItemNumber=498. Accessed August 17, 2015.
- Bennett GL, Graham CE, Mauldin DM. Morton’s interdigital neuroma: a comprehensive treatment protocol. Foot Ankle Int. 1995;16:760-763.
- Saygi B, Yildirim Y, Saygi EK, Kara H, Esemenli T. Morton neuroma: comparative results of two conservative methods. Foot Ankle Int. 2005;26(7):556-559.
- Gurdezi S, White T, Ramesh P. Alcohol injection for Morton’s neuroma: a five-year follow-up. Foot Ankle Int. 2013;34(8):1064-1067.
- Womack JW, Richardson DR, Murphy GA, Richardson EG, Ishikawa SN. Long-term evaluation of interdigital neuroma treated by surgical excision. Foot Ankle Int. 2008;29:574-577.
- Barrett SL, Rabat E, Buitrago M, Rascon VP, Applegate D. Endoscopic decompression of intermetatarsal nerve (EDIN) for the treatment of Morton’s entrapment—multicenter retrospective review. Open J Orthop. 2012;2:19-24.
- Gauthier G. Thomas Morton’s disease: a nerve entrapment syndrome. A new surgical technique. Clin Orthop Relat Res. 1979;142:90-92.
This article originally appeared on MPR