In patients with Morton neuroma whose symptoms persist despite a trial of first-line non-operative management, a structured next-step approach is indicated to achieve reduction of forefoot pain.
Non-operative conservative measures were trialled first: patient education, use of wide toe box shoes, and a Metatarsal Bar orthotic insole designed to spread the metatarsal heads and relieve pressure on the neuroma.
The goals of this line were relief of pressure on the neuroma and improvement of forefoot pain symptoms. When these are not sufficiently achieved, escalation is warranted.
Corticosteroid is currently the mainstay of injection treatment for Morton's Neuroma.
Their results suggested that 82% of patients who received 2–3 steroid injections reported complete satisfaction at 12 months.
The steroid reduces the inflammation surrounding the neuroma and therefore reduces pain and also local pressure effects.