MSK Mortons neuroma (plantar digital neuroma)

Borders Ref Help Toolkit
NHS Borders

Morton’s Neuroma (or Plantar digital neuroma) is a soft tissue nerve entrapment, which commonly affects one or more of the small nerves in the foot. The condition most commonly occurs in the second and third web spaces. It can cause mild to severe pain between the joints in the front of the foot and there is often numbness in one or more toes.

Diagnosis can be aided by lateral compression across the forefoot. Increased pain and sometimes a click are elicited (Mulder’s sign) aiding diagnosis.

If patients do not improve to an acceptable level within the community podiatry service, they will be escalated to the Podiatry MSK or Foot and Ankle Orthopaedic service.

Who to refer, who not to refer, how to refer

Who to Refer

  • Anyone regardless of age with pain caused in the forefoot suspected to be a Neuroma if self-management measures have failed.

Who Not to Refer

  • Patients who are undergoing management for this condition with another service.

How to Refer 

Refer via SCI Gateway or ask patient to complete self-referral form here: podiatry-self-referral.docx (live.com)

Primary care management

  • Provide patient leaflet – Morton’s Neuroma: Information for Patients
  • Consider pain relief
  • Discuss footwear – shoes should be wide enough at the toes not to put pressure on the affected nerve, and lacing or Velcro attachments will hold shoes securely on the foot which will reduce foot movement and pain.
  • If no improvements after following advice for 6 weeks refer or advise patient to self-refer to Podiatry Community Service

Resources and links

National and local websites for further information

For patients:

NHS Borders Plantar Fasciitis information leaflet: Mortons Neuroma: Information for Patients (NHS Borders)

Self-referral form for NHS Borders Podiatry: podiatry-self-referral.docx

For Health Professionals:

NHS Inform page for pain in the ball of the foot: Pain in the ball of the foot | NHS inform

Local service details

Podiatryadmin@borders.scot.nhs.uk

Editorial Information

Last reviewed: 20/05/2024

Next review date: 20/05/2026

Author(s): Laura Bolan.

Author email(s): laura.bolan3@nhs.scot.