I’d like to avoid surgery for my Morton’s neuroma (as well as other permanent options like alcohol injections), so I’m trying all of these first. I’ve spent a ton of time trawling the internet for all of this, so here’s the comprehensive list. Hopefully it can help someone else.

Mechanical

Footwear\ These changes take pressure off metatarsals and encourage them to spread.

  • Correct Toes
  • Metatarsal pads
  • Traditional orthotics (these can be a crutch, not a solution on their own)
  • Low heel! Even running shoes often have a high heel-to-toe drop
  • Toe socks (Injinji)
  • Wide/high toe boxes (a tip - take out the insole, stand on it in bare feet, see if you hang over the edge)
  • Thinner/looser socks
  • Skip bottom eyelets when lacing shoes
  • Well-fitted shoes (if they are too big, you slide around and that puts more pressure on it)
  • Adapt existing shoes: use a shoe stretcher; trim above tongue or beside toes to allow toes to spread; use thinner inserts

Functional correction

Calming the nerve and surrounding tissues

Reducing inflammation/pain

  • Ice, ice massage
  • Cortisone shots (they’re not great for other tissues though)
  • Anti-inflammatories (NSAIDs, herbal)
  • Ultrasound?
  • Rest (but not too much)
  • Prescription meds for nerve pain

Reducing pressure on the nerve

  • Cushioned shoes
  • Change up shoes frequently to put pressure on different areas
  • Yoga Toes (improve mobility)
  • Toe spacer socks while sleeping

Promoting bloodflow/healing

Living with the pain

  • Find another form of exercise
  • “Lean into” other hobbies
  • Keep up activity as much as possible - drive, bike, use a cane, go slow
  • Meditation, therapy

Ideas random people have mentioned

  • Muscle relaxer cream
  • CBD cream
  • Oral THCA for nerve pain
  • Acupuncture
  • Prolotherapy
  • Chiropractors (breaking up scar tissue)
  • Could be misdiagnosed as tarsal tunnel syndrome?
  • Nerve pain: neuro-eze/neuro-one topicals, lidoderm patches
  • Ball of foot wrap
  • Nerve flossing (instructions here and here)
  • Treat issues with lower back? L5 nerve; core strengthening
  • This massage which seems easy to do wrong
  • Other injections: capsaicin, stem cells, B vitamins, platelet rich plasma
  • Trim hole in insole under neuroma

About taping

Taping strategies:

  • https://www.youtube.com/watch?v=JdEv7ayilec
    • piece 1: cut four strips most of the way down
    • anchor behind heel
    • flex toes, put strips between and above toes with some stretch, anchor midfoot
    • piece 2: short piece of tape to cover ends of strips
  • https://www.youtube.com/watch?v=Db9qgYPrku4
    • piece 1: cut piece that fits all the way around ball of foot
    • anchor near big toe, stretch ~50-70% under foot and anchor on outer side of foot
    • stretch over foot (50-70%) and anchor by big toe
    • piece 2: fits over foot horizontally just behind first piece, stretch 70% and put over foot, then anchor sides
  • https://www.youtube.com/watch?v=GqgQF4D792g
    • piece 1: 10 inch piece with two diamond holes in the middle, fit over problematic toes, 10% tension for the middle third of tape
    • anchor at ends
    • piece 2: go around under base of foot with 10% tension, anchor top midfoot
  • https://www.youtube.com/watch?v=u_BTmrYSxg8
    • piece 1: cut three strips most of the way down
    • anchor top midfoot, put strips between toes with some tension about an inch on either side
    • anchor the rest on bottom of foot
    • piece 2: strip under foot on ball, 100% tension , anchor at sides of foot
  • https://www.youtube.com/watch?v=xLA11cJSp8A&t=11s
    • piece 1: cut strip to go mostly around ball of foot
    • stretch about 100% under ball of foot
    • anchor at sides and top

What’s in common between these strategies?

  • piece under ball of foot, between 10-100% stretch
  • piece that goes between toes

Why does taping work? (from comments on https://www.youtube.com/watch?v=Db9qgYPrku4)

If you wrapped the tape completely around with consistent stretch all the way thru then yes, it would compress the tissue. That’s why I incorporated anchor points on both ends with zero stretch, so the tape behaves as a cross fiber taping for increased circulation, which will create surface area by lifting the skin towards least resistance. away from the body.


Resources

There are a million articles that say roughly the same thing - metatarsal pads, orthotics, cortisone shots, surgery. Here are some more thorough and alternative views. They may or may not be reliable.

Some simple conservative treatments; more thorough than other sites

I like this article - thorough review of someone’s experience

This guy has a lot of ideas and opinions; he says you should always address all three of mechanical, inflammatory, and neurological issues.

A lot of alternative views here, with focus on massage/stretching.

My current strategy

  • Strength
    • Ankle: band kicks (20x), alphabet (1x)
    • Foot: towel grab (20x), toe raises (10x)
    • Calf: sitting calf raises (20x)
  • Mobility
    • Calf stretching (3x30s, 3x per day)
    • Foot rolling (3x per day)
    • Metatarsal mobilization
    • Nerve glides (10x, 3x per day)
  • Inflammation
    • Vitamins/supplements
    • L-arginine cream
    • (Ice and/or KT tape when painful)
  • Footwear
    • Metatarsal pads in house shoes
    • Orthotics + Altras outside
  • General fitness
    • Yoga
    • Pilates, body weight workouts
    • Daily walking