Morton's Neuroma

Question 1

Where is the pain most likely to be located in Morton’s Neuroma?

Answer 1

B

Question 2

What is Morton’s Neuroma?

Answer 2

A benign neuroma affecting the intermetatarsal plantar nerve. The nerves become scarred and thickened and then caught between the metatarsal bones, most commonly in the third inter-metatarsophalangeal space.

Question 3

Is Morton’s Neuroma more common in men or women? And what ratio?

Answer 3

More common in women

4:1

Question 4

What is Mulder’s sign? (An examination in Morton’s neuroma)

Answer 4

One hand tries to hold the neuroma between the finger and thumb. The other hand squeezes the metatarsals together. The pressure will cause pain, paresthesia and tingling. A click may be heard as the neuroma moves between the metatarsal heads

Question 5

What are some symptoms of Morton’s neuroma?

Answer 5

• Electric shock/Burning like pain with particular shoes.
• Feels like a pebble is in their shoes

Question 6

What is the management of Morton’s Neuroma?

Answer 6

• Avoid high-heels
• Metatarsal pad
• CKS recommends referral if symptoms persist for > 3 months despite footwear modifications and the use of metatarsal pads
• Orthotists may give the patient a metatarsal dome orthotic
• Other secondary care options include corticosteroid injection and neurectomy of the involved interdigital nerve and neuroma.