BACKGROUND: Morton's neuroma is a common, paroxysmal neuralgia affecting the web 
spaces of the toes, typically the third. The pain is often so debilitating that 
patients become anxious about walking or even putting their foot to the ground. 
Insoles, corticosteroid injections, excision of the nerve, transposition of the 
nerve and neurolysis of the nerve are commonly used treatments. Their 
effectiveness is poorly understood.
OBJECTIVES: To examine the evidence from randomised controlled trials concerning 
the effectiveness of interventions in adults with Morton's neuroma.
SEARCH STRATEGY: We searched the Cochrane Neuromuscular Disease Group trials 
register (searched January 2003), MEDLINE (January 1966 to January Week 2 2003), 
EMBASE (January 1980 to February Week 2 2003), and CINAHL (January 1982 to 
February Week 1 2003).
SELECTION CRITERIA: Randomised or quasi-randomised (methods of allocating 
participants to an intervention which were not strictly random e.g. date of 
birth, hospital record, number alternation) controlled trials of interventions 
for Morton's neuroma were selected. Studies where participants were not 
randomised into intervention groups were excluded.
DATA COLLECTION AND ANALYSIS: Two reviewers selected trials for inclusion in the 
review, assessed their methodological quality and extracted data independently.
MAIN RESULTS: Three trials involving 121 people were included. There is, at 
most, a very limited indication that transposition of the transected plantar 
digital nerve may yield better results than standard resection of the nerve in 
the long term. There is no evidence to support the use of supinatory insoles. 
There are, at best, very limited indications to suggest that dorsal incisions 
for resection of the plantar digital nerve may result in less symptomatic 
post-operative scars when compared to plantar excision of the nerve.
REVIEWERS' CONCLUSIONS: There is insufficient evidence with which to assess the 
effectiveness of surgical and non-surgical interventions for Morton's neuroma. 
Well designed trials are needed to begin to establish an evidence base for the 
treatment of Morton's neuroma pain.