Living With Chronic Pain

Morton’s Neuroma Treatments

As discussed in last week’s post, a Morton’s neuroma is a fibrosis or scarring that occurs most commonly on the plantar digital nerve between the 2nd and 3rd or 3rd and 4th toes. It can become so severe it interferes with daily activities.

Here are a few ways to treat it at home:

  • Stop any inciting events or activities that perpetuate the inflammation e.g., poorly fitting shoes, impact sports, excessive walking or standing, for a brief period of time. Often that’s enough to stop further irritation and fibrotic formation.
  • Try massaging the foot and toes at the site of any mass or pain in order to decrease swelling and encourage blood flow.
  • Elevate your feet and apply ice to the painful area at the end of a long day to limit inflammation.
  • Insert arch supports or extra padding to ball of the foot to decrease pressure on the nerve. Over the counter shoe pads can increase padding on the ball of the foot and reduce pressure on the affected toes. If helpful, but not enough to relieve all your symptoms, custom orthotics from your healthcare provider may be the answer.
  • Change to low heeled, wide based shoes to allow toes to spread and reduce compression. Two inches or less is recommended.
  • Avoid socks that are too small or tight. Often overlooked, they can be the culprit in causing or increasing symptoms.
  • Decrease weight. Just one extra pound above your ideal weight can increase pressure on the ankle and feet by as much as eight pounds according to the American College of Foot and Ankle surgeons. The higher your weight the more stress the soft tissues, bones and joints experience. Most people are shocked they lose shoe sizes in the feet as well with weight loss.
  • Improve foot mobility and strength. Weakness in the smaller intrinsic muscles of the foot as well as the ankle is often found in those who have Morton’s neuromas. This may be creating the biomechanical issues that allow for its formation. Exercises as discussed below can help.
  • Improve balance. Poor balance causes the foot and ankle to work harder to compensate and can lead to abnormal biomechanical changes in the foot. This can lead to a multitude of issues, such as a Morton’s nueroma, plantar fasciitis, tendonitis, or bunions. Simple maneuvers can be done all day long- balance on one foot when safe and close to support when needed multiple times a day. Stand up without using your arms. Walk heel to toe for a few steps.
  • Taping the ball of the foot/toes may change the abnormal impact and relieve symptoms. Ensure the tape isn’t too tight around the forefoot, restricting the normal foot expansion when walking. One option is to keep the two ends of tape from meeting.
  • Short term use of over the counter medications or NSAIDs, non steroidal anti inflammatory drugs, such as Motrin or Aleve may help. Always clear with your provider before using since they may be contraindicated with other medications or medical situations such as renal disease, indigestion or anticoagulants.
  • Use a topical cream whether over the counter or prescribed to decrease inflammation and reduce pain.


As with any part of the body exercise improves circulation, increases flexibility and boosts strength. It also restores the foots natural biomechanics reducing strain on the affected area.

Any exercise that stretches the lower leg, calf, Achilles tendon and sole of the foot can help relieve pain from a Morton’s neuroma. Always start slowly so it doesn’t aggravate the nerve and exacerbate the pain.

  • Plantar fascia stretch (see post on plantar fasciitis). Put a spread out towel on the ground and place the tip of your foot on the edge. Then scrunch your toes to move the towel towards you until the towel is under your foot. Adding a weight to the far edge of the towel can make it even more challenging.
  • Sitting on the ground wrap an exercise band around the big toe. Extend the leg and use the band to gently pull back the foot. Then move the big toe forward to push the foot down. Repeat several times.
  • Put a golf ball or tennis ball under your foot and roll it from the arch to the toes for several minutes. Put marbles in a shoe box and leave it under your desk at work. It can be used to massage your feet whenever you have a free moment without anyone else knowing your secret.
  • Gastocnemius stretch. Place one leg behind the other while standing. Lean against the wall and gently push the back leg’s heel to the floor feeling a pull in the back of the leg. Hold for 30 seconds. Release and stretch again three times.
  • For strengthening lead with your big toe and complete a figure eight. Or write the alphabet in the air.
  • Start with toe raises while holding onto a chair. To add balance do them without the chair but have it ready when needed to prevent a fall.
  • Grasp the heel in one hand with the other hand under the ball of the foot and toes. Pull the forefoot and toes towards your leg until you feel a pull along the bottom of the foot.

Research shows 80% of Morton’s nueromas can be treated effectively through conservative measures. But when it persists medical intervention may be required.

Medical treatments

  • Physical therapy. Research shows a combination of manipulation, massage, ultrasound, cryotherapy, deep tissue massage, phonophoresis, and stretching exercises that mobilize and strengthen the affected joint produce effective results.
  • Corticosteroid shots inject a powerful anti- inflammatory into the area of the neurons to decrease swelling and inflammation. A burst of oral steroids may also help. Alcohol injections have been touted as a powerful treatment but there are no randomized, double-blind studies that verify this treatment works in comparison to steroid injections.
  • Custom shoe orthotics can bring the foot into proper alignment and decrease pressure on the neuroma site to reduce symptoms or progression.
  • As a last resort, when all other conservative methods fail, surgery may be an option. On an outpatient basis, the fibrotic, inflamed tissue can be excised necessitating just a few weeks of recovery. But it can result in permanent numbness.
  • Cryosurgery is a minimally invasive procedure that uses extreme cold to destroy the thickened nerve sheath. This decreases pain signals and minimizes nerve degeneration. By leaving the nerve intact, the risk of sensation loss or forming a residual stump is low. Recovery time is minimal, requiring limited weight bearing without a boot or crutches.

One out of three people will suffer from a Morton’s Neuroma. When pain or interference with daily activities persist see your healthcare provider. It doesn’t have to keep you from being active or enjoying life.


Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.