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Morton Neuromas (Inter-metatarsal neuroma} of the foot is a common problem that results in swelling and inflammation of the nerves, located between the 2nd and 3rd, or 3rd and 4th metatarsals of both feet. It can present gradually over time, or very rapidly when the onset and cause of the neuroma is associated with a particular event. When the pain is chronic, progressive, and clearly related to the amount of time spent walking and standing, the intense and disabling nature of the pain is usually precipitated by a twisting motion of the metatarsal region during weight bearing.

  The diagnosis is made primarily with a history of signs and symptoms, including:

• Numbness in the early stages between the two involved toes.
• Constantly changing levels of burning pain in the middle of the foot
• Sharp, shooting pain that starts under the metatarsal region, and then radiates into the two adjacent toes. 
• Pain with palpation of the inflamed intermetatarsal nerves, and a characteristic “click” with manipulation of the metatarsal bones, are all thought to be classical signs of a Morton’s Neuroma. Computerized imaging techniques will document but are not necessary to diagnose this benign lesion of the foot.

What is the cause of a painful Neuroma?

Cause: Progressive enlargement of the nerve begins with pronation of the foot as we walk, then instability of the metatarsals, and finally, pressure and grinding of the bones on the nerves.

Treatment: Any successful treatment usually involves decreased standing and walking. Patients say it is the only thing they can do to take the pressure off of the nerves and reduce pain. Many treatments just mask the symptoms temporarily. OTC and prescription pain medication, anti-inflammatories, nutritional supplements, and even cortisone injections, provide only partial relief on a temporary basis. As the pain intensifies and becomes more problematic for the patient, the chronic nature of the condition becomes obvious as the symptoms return. These treatments definitely do not treat the cause of the neuroma.Surgical excision of this benign nerve tumor is a common medical recommendation

What do you do when medication, cortisone and alcohol injections, physical therapy, metatarsal pads, arch supports, and prescription orthotics have all failed? What do you do when you have changed the style of the shoes you wear, decreased activity to next to nothing, and done everything but surgery? Even when surgeons fully warn their patients of the inherent risks and poor overall success, patients, mostly out of desperation, consent to surgery.

Even when the surgical excision is successful and without the many complications of nerve surgery in general, it is not un-likely for you to see signs of another one before the first one has fully healed. Brent A Jarrett DPM (Physician and Surgeon of the Foot)

Stop more Pronation and you will stop more Pain.

What orthotic is best for neuromas?

Many patients report some benefits associated with the use of orthotic devices with a variety of pads and cushions. Unfortunately, few patients get the help they need, and either quit using the orthotics and just further diminish their weight bearing activity, or accept the risks of surgery. No orthotic variation, extension, pad or cushion currently on the market, other than Theta-Orthtoics, Provides enough help to consistently treat a difficult neruoma successfully.

I started treating Morton’s Neuroma patients in 1980 as a surgical resident. I started treating my private neuroma patients with Theta-orthotics In 1985. Once I fully understood theta and was teaching patients what they needed to know in order to apply Theta effectively, the percentage of neuroma patients who went on to to at least one neuroma surgery dropped from 50 to 5 percent. Theta should be your treatment of choice and could be your surgical alternative.  Brent A Jarrett DPM.

Dear Dr Jarrett,
  I have been plagued with Neuroma problems for over twenty years . I had the Neuroma's surgically removed in 1994 (both feet) . Within three years I was troubled again by the constant stabbing pain which would persist.. that is, until July 2006. I got my first pair of Theta-orthotics , they were 15 's. It took me about 4 days to get used to them. I followed the instruction almost to the tee. I needed this to work. I graduated into the 20's and then the 25's .About the 10 th month my feet were hurting again. I called your help line. Your consultant was so understanding and had just the solution to my problem.
   Apparently I didn't read the part that said this would decrease your foot size by re-shaping your foot to take the pressure off the Neuroma's. Well... There I go from a 6 W to a 5... It worked ! It was like having new feet. I was so pleased...
  The added and perhaps" biggest bonus" was, that while helping my feet, my need for chiropractic manipulation has decreased ( a lot!). I was walking differently and noticed my lower back had less stress. It has definitely helped with my spinal alignment, (which is key to whole body health.) I am more active than ever now. I no longer have the stabbing pains that only a Neuroma sufferer could know. The only problem I have encountered was the loss of my 30's in a recent move and I am back to my 25's. I have some soreness and discomfort so I have ordered my 30's again and some 35's. I can't wait for them to arrive!
  My husbands feet are next! Sometimes he works long days and his feet are sore and tired. I am going to get a pair for him if you suggest these can make just plain old tired feet better?
  I have been criticized by several people about buying anything of this nature on line..I assure them the three Podiatrist specialists I have had in the past had never taken a cast of my feet to make custom orthotics like you did. nor take into consideration any of the things you asked on the questionnaire I filled out. They all sent me to Foot Locker.To buy pre made stamped out inserts. My chiropractor sends "we miss you notes" but I just don't need to go.
  Well, I trust your orthotics Dr Jarrett, because they work and I would recommend anyone to try them. I can't begin to thank you enough. Your staff members are precious . When I call they are always helpful and friendly... Thank you again for developing these orthotics. Wish I would have known about these a long time ago!
 
Best Wishes to you and your staff,
 
Ruby Palmer

Change the way you walk and stand...stop the pain...Dr Brent A Jarrett

Theta-Orthotics, PO Box 1574, Riverton Ut 84065, 800-558-4382, thetaorthotics@gmail.com