Morton's Neuroma Diagnosis and Treatment Approaches

Morton’s neuroma is a compressive neuropathy of the common plantar digital nerve, most frequently occurring between the third and fourth metatarsal heads, and presents clinically with forefoot pain, paraesthesia and a characteristic burning sensation. Diagnosis rests on a combination of focussed history, physical examination and imaging modalities. Clinical tests such as the Mulder click and assessment of interphalangeal divergence aid in differentiation from conditions such as intermetatarsal bursitis or metatarsalgia. Imaging techniques—including high-resolution ultrasound and weight-bearing radiography—enhance diagnostic accuracy by visualising nerve enlargement, interdigital bursal fluid and toe divergence. Management follows a stepwise approach, beginning with conservative measures such as footwear modification, orthoses and manual therapies. When non-surgical measures are insufficient, image-guided injections of corticosteroids or sclerosing agents can deliver symptomatic relief. Should symptoms persist, surgical neurectomy or decompression offers durable pain resolution, with choice of plantar or dorsal approach tailored to patient factors and surgeon expertise. Emerging research continues to refine diagnostic thresholds, optimises interventional guidance and compares surgical approaches to inform best practice.

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Morton's Neuroma Diagnosis and Treatment Approaches publication trend

The graph below shows the total number of articles in morton's neuroma diagnosis and treatment approaches across all publications each year (not limited to Nature Index journals).

Technical terms

Morton’s neuroma: A compressive enlargement of the common plantar digital nerve in the forefoot causing neuropathic pain.

Intermetatarsal bursitis: Inflammation of the fluid-filled sacs between metatarsal heads, often mimicking neuroma symptoms.

Neurectomy: Surgical excision of a segment of nerve to alleviate chronic neuropathic pain.

Ultrasound guidance: Real-time use of ultrasonography to direct injections or interventions with precision.

Visual Analogue Scale (VAS): A patient-reported continuum measuring pain intensity from no pain to worst imaginable pain.

References

1. Diagnostic Considerations of Intermetatarsal Bursitis: A Systematic Review. Diagnostics (2023).
2. The effectiveness of non‐surgical interventions for common plantar digital compressive neuropathy (Morton's neuroma): a systematic review and meta‐analysis. Journal of Foot and Ankle Research (2019).
3. Plantar and dorsal approaches for excision of morton’s neuroma: a comparison study. BMC Musculoskeletal Disorders (2022).
4. High-Resolution Ultrasound of the Forefoot and Common Pathologies. Diagnostics (2022).
5. The Vulcan salute sign: a non-sensitive but specific sign for Morton’s neuroma on radiographs. Skeletal Radiology (2021).