Civinini Morton's Syndrome (CMS), better known as Morton's Neuroma, is a benign 
enlargement that typically affects the third common digital branch of the 
plantar nerve. It is a common cause of metatarsalgia leading to debilitating 
pain. It prefers the female gender, with a female to male ratio of 5:1 and an 
average age of 50 years at time of surgery. Precise aetiology remains under 
debate, with four etiopathogenetic theories often cited in the literature. 
Clinical symptoms, physical exam and instrumental evidence are important in 
assessing and grading the disease. Biomechanics seem to play an important role, 
especially regarding the usefulness of correct footwear. The first approach in 
the early stages of this condition usually begins with shoe modifications and 
orthotics, designed to limit the nerve compression. In order to prevent or delay 
the development of CMS, shoes should be sufficiently long, comfortable, broad 
toe-boxed, should bear a flat heel and a sufficiently thick external sole which 
should not be excessively flexible. Most authors suggested that an insole with 
medial arch support and a retrocapital bar or pad, just proximal to the 
metatarsal heads, displaces the pressure sites and can be beneficial to relieve 
the pain from the pinched nerve. A threshold period of 4.5 months appears to 
emerge from the results of the analysed studies, indicating that, beyond this 
period and in neuromas larger than 5-6 mm, orthotics and/or shoes modifications 
do not seem to give convincing results, proving to be more a palliation for the 
clinical condition to allow an acceptable life with pain rather than a real 
treatment.