Alternatively, making the incision from the ventral side (the sole of the foot) allows more direct access to the affected nerve without cutting other structures. However, this approach requires a greater post-operative recovery time in which the patient must avoid weight-bearing on the affected foot, because the ventral aspect of the foot is more highly enervated and impacted by pressure when standing. It also carries an increased risk of scar-tissue formation in a location that causes ongoing pain.When a patient has multiple neuromas in the same foot, the most common surgical approach is to remove them all using a single incision.Cryogenic neuroablation (also known as cryoinjection therapy, cryoneurolysis, cryosurgery or cryoablation) is a lesser-known alternative to neurectomy surgery. It involves the destruction of axons to prevent them from carrying painful impulses. This is accomplished by making a small incision (~3 mm) and inserting a cryoneedle that applies extremely low temperatures of between −50 °C to −70 °C to the nerve/neuroma, resulting in degeneration of the intracellular elements, axons and myelin sheath (which houses the neuroma) with wallerian degeneration. The epineurium and perineurium remain intact, thus preventing the formation of stump neuroma. The preservation of these structures differentiates cryogenic neuroablation from surgical excision and neurolytic agents such as alcohol. An initial study showed that cryoneuroablation is initially equal in effectiveness to surgery but does not have the risk of stump neuroma formation.An increasing range of procedures are being performed at specialist centers to treat Mortons neuroma under ultrasound guidance.
Footwear and orthotics are most effective in neuromas that have existed less than four and a half months and are smaller than 4–5 millimetres (0.16–0.20 in). To prevent or treat Mortons neuroma, comfortable shoes that are sufficiently long and have a wide toe box, flat heel, and thick sole are recommended.Corticosteroid injections can relieve inflammation in some patients and help end the symptoms. For some patients, however, the inflammation and pain recur after some weeks or months, and corticosteroids may only be used a limited number of times because they cause progressive degeneration of ligamentous and tendinous tissues. About 30% of people who receive steroid injections go on to have surgery. According to a 2021 review, it is most effective in neuromas smaller than 6.3 millimetres (0.25 in).Sclerosing alcohol injections are an increasingly available treatment alternative if other management approaches fail. Dilute alcohol (4%) is injected directly into the area of the neuroma, causing toxicity to the fibrous nerve tissue. Frequently, treatment must be performed two to four times, with one to three weeks between interventions. A 60–80% success rate has been achieved in clinical studies, equal to or exceeding the success rate for surgical neurectomy, with fewer risks and less significant recovery. If done with more concentrated alcohol under ultrasound guidance, the success rate is considerably higher and fewer repeat procedures are needed.Radiofrequency ablation is also used in the treatment of Mortons neuroma.