Morton’s Neuroma Nerve Block Injections

Morton’s neuroma is a swollen or thickened nerve in the ball of the foot, most commonly in the area between the second and third, or between third and fourth, toes. Morton’s neuroma can be caused when the toes are squeezed together for too long, or too often. Of course, high heeled shoes (and everything similar) can exacerbate this condition. Morton’s neuroma can cause a very painful burning or sharp pain in the foot that feels worse when walking. Moreover, Morton’s neuroma may present as feeling as though standing on a pebble in the shoe. In addition to the treatment options listed below, Morton’s neuroma can be managed by wearing appropriate footwear, allowing time for rest, and certain massage techniques.


As with all types of chronic nerve pain, there are many treatment options available including cryotherapy (extreme cold), medications and nerve blocking injections. Nerve Block injections involve injection of a numbing solution into a selective nerve in an attempt to treat and manage pain. The injection can include a steroid (to reduce inflammation) and/or lidocaine or marcaine (to reduce pain). Nerve block injections are used to effectively “turn off” such nerves, and thus reduce any associated inflammation. The effect of these injections lasts between one and four weeks and can be repeated as required. With some conditions however, patients report a total reduction in pain since the initial over- activity of the nerve has been counteracted. In some instances, the patient may experience a more long term loss of pain as a result of localized anesthesia.

The types of medications used are not predetermined, since many options are available. Of course, ultrasound or fluoroscopy (image-guided injections) may work best, since surface anatomy may not be enough to target the extremely small surface area of the nerves in question.

Remember, nerve blocks are not the best treatment for all pain types. Even when they are appropriate, they are usually more effective as part of a more comprehensive treatment strategy.

Depending on the circumstances, complete destruction of the nerve (as opposed to temporary numbing through a local anesthetic) could be considered. This is referred to as a rhizotomy (currently not performed at the clinic). Aside from the obvious complications of nerve destruction, permanently damaging a nerve may inadvertently and inevitably damage the soft tissue adjacent to that nerve as well.



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