Non Operative Treatments FAQ
They can help. Slightly separating the toes with a wedge puts less pressure on the neuroma. We tend to produce a custom wedge called an "ortho-digital silicone device" for this purpose – this is made from a silicone putty that sets to the shape of the toes. Adhesive pads, made from materials like semi-compressed felt, can be beneficial and can be very helpful for dancers who dance without shoes.
Please see our section on causes / footwear for comprehensive advise on which shoes appear to be best to manage the symptoms of Morton’s neuroma.
There is limited evidence for the effectiveness of creams or topical agents. However, we have seen limited benefit from capsaicin cream (made from chillies). We have not seen any positive effects from Voltarol gel and other inflammatory creams. Some patients with complex presentations have occasionally been helped by lignocaine cream and patches (Versatis).
A tens machine emits a low current which causes tingling to the point where it is applied. This acts as a form of counter irritation which some patients find helpful. In our view, it plays a limited role in treating the condition.
There are a number of drugs that can help with the symptoms of forefoot neuritis and Morton’s neuroma. These include: Codeine and other opioids This drug is recognised as being more effective at controlling nerve pain compared to other pain killers, including anti-inflammatories such as Nurofen. Side effects from Codeine include nausea, constipation and lethargy. Amitriptyline This can help some patients with nerve pain and works by releasing the chemical serotonin in the brain. It is also used for depression. The drug is often tolerated by patients, but side effects include confusion, numbness and tingling in arms and legs, headache, constipation or diarrhoea, blurred vision, skin rash, swelling of the face and tongue, and nausea. Pregabalin The action of this drug is not fully understood. It is prescribed for epilepsy, but at lower doses can be effective for various forms of chronic pain. The aforementioned drugs are, in our view, rarely used except where patients have developed a more complex neurological condition such as Complex Regional Pain Syndrome.