Treating Morton’s Neuroma From A Variety Of Angles

A patient recently contacted me after suffering from a Morton's neuroma on the left foot for the past seven months. His podiatrist diagnosed this upon physical examination.

In the past seven months, this patient has tried multiple treatments before seeing a podiatrist. He completed three months of physical therapy. He has tried four treatments of acupuncture, which only worked for a day or two. An orthopedist diagnosed the patient with metatarsalgia and the patient wore a shoe the doctor gave him for six weeks.

Following the podiatrist’s diagnosis of Morton’s neuroma, for the past eight weeks, the patient has worn a pad his podiatrist gave him and an insert he had purchased upon the DPM’s recommendation. The patient has been wearing shoes with a wide toe box since mid-September. He ices the foot daily and uses essential oils such as lavender, peppermint and rosemary every night. The patient has had to stop going to the gym. He says this was “very difficult” as he enjoys martial arts but it involves a lot of pivoting and weightbearing on the left foot.

Although the “super intense” pain has improved somewhat, the patient is still in pain. He will soon have magnetic resonance imaging and a first cortisone shot. If the cortisone shots do not help the patient, what is his next step?

Morton's neuroma pain is in essence nerve pain, specifically the L5 nerve coming off the low back. I mention this because one should always consider evaluation if the pain is only local to the foot or if one suspects a double crush syndrome.

The treatment for Morton’s neuroma should always focus on three angles: mechanical, anti-inflammatory and neurological. The metatarsal pads, shoes, wide toe boxes, orthotic devices are all mechanical changes. Nerve treatments that help are acupuncture, transcutaneous electrical nerve stimulation (TENS), topicals like Neuro-Eze (Foot Express) or NeuroOne (NeuroOne Medical Technologies), compounding prescription meds, neural flossing, alcohol sclerosing injections, oral nerve meds and possibly low back treatments.

Editor’s note: This blog originally appeared at https://www.drblakeshealingsole.com/2019/01/mortons-neuroma-email-advice.html  . It is reprinted with permission from the author.