Inter-Digital Neuroma


A neuroma is a benign tumour of a nerve. Morton's neuroma is not actually a tumour, but a thickening of the tissue that surrounds the digital nerve leading to the toes. It occurs as the nerve passes under the ligament connecting the toe bones (metatarsals) in the forefoot.


Signs and Symptoms:


Normally, there are no outward signs, such as a lump, because this is not really a tumour. There is usually a burning pain in the ball of the foot that may radiate into the toes. The pain generally intensifies with activity or wearing shoes. Night pain is rare. There may also be numbness in the toes, or an unpleasant feeling in the toes. High-heeled shoes, which put the foot in a similar position to the push-off, can also aggravate the condition. Tight, narrow shoes also aggravate this condition by compressing the toe bones and pinching the nerve.

Diagnosis and Treatment

During the examination, your physician will feel for a palpable mass or a "click" between the bones. He or she will put pressure on the spaces between the toe bones to try to replicate the pain and look for calluses or evidence of stress fractures in the bones that might be the cause of the pain. Range of motion tests will help rule out arthritis or joint inflammations. X-rays may be required to rule out a stress fracture or arthritis of the joints that join the toes to the foot.

Initial therapies are non-surgical and relatively simple. They can involve one or more of the following treatments:






Operative Procedure

The nerve can be approached through a longitudinal cut over the top of the foot between the toes, occasionally your surgeon might approach from the under surface of the foot (sole). Once through the skin and the through the fascia, a small segment of the nerve is removed. This procedure is usually done as a day case procedure mostly under general anaesthetic


Recovery from this surgery needs to take into consideration any other operative procedures that were done in conjunction with this surgery. Patient can weight bear during this period. A bandage is worn for 2 weeks and once the wound is healed you can wear comfortable shoes.

Specific complications

  • Infection around the surgical wound
  • Blood Vessel (Vascular) Injury. There are small blood vessels that runs along the side of the nerve. If these are injured, the blood flow to the tip of the toe may be lost. This can result in necrosis of the tip of the toe. Although rare, this may lead to a partial amputation of the toe.
  • Neuroma formation: The resected nerve end can grow and become sensitive this could result in reoccurrence of symptom’s and pain.

General Complications

  • Wound healing problems
  • Blood clots (DVT)
  • Pulmonary embolism (PE): Although much less likely for toe surgery, blood clots and PE’s can still occur.

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