Morton's neuroma is a thickening and irritation of one of the small nerves that run between the long bones of the foot to the toes, most often between the third and fourth toes. The nerve becomes compressed and inflamed, producing pain and altered sensation in the forefoot.
People often describe burning pain into the toes, numbness, or the feeling of a pebble underfoot or a sock bunched up. Tight or narrow shoes and high heels make it worse, which is why footwear is the first thing addressed.
Symptoms
Typical complaints include:
- Burning or sharp pain in the ball of the foot, often into the toes
- A sensation of a pebble underfoot or a bunched-up sock
- Numbness or tingling between the toes
- Relief when taking the shoe off and rubbing the foot
How it is diagnosed
Morton's neuroma is usually diagnosed by examination, squeezing the forefoot reproduces the pain and sometimes a click. Ultrasound or MRI confirms it and rules out other causes when the picture is unclear, and a diagnostic injection can help.
Most Morton's neuromas improve without surgery. Dr. Lee starts with the highest-yield change, wider, lower-heeled shoes with a roomy toe box, along with a metatarsal pad that takes pressure off the nerve, and activity modification.
A corticosteroid injection relieves many cases that do not settle with footwear alone. For persistent pain, options include further injections or surgery to decompress or remove the irritated nerve. The plan escalates only as far as the symptoms require.
Non-surgical treatment
Most patients improve with:
- Wider, lower-heeled shoes with a roomy toe box
- A metatarsal pad to offload the nerve
- Activity modification
- A corticosteroid injection for cases that do not settle with footwear
Surgical treatment
For pain that persists despite footwear changes and injections, surgery either decompresses the nerve by releasing the tight tissue over it or removes the irritated segment of nerve. The choice depends on the situation and prior treatment.
Recovery timeline
Recovery depends on the treatment:
- Non-surgicalFootwear changes and a metatarsal pad bring relief over weeks; an injection can speed it.
- After surgery, weeks 0 to 4Protected weight-bearing in a stiff-soled shoe, with wound care.
- Weeks 4 to 8Progressive return to normal footwear and activity.
What patients commonly misunderstand
Two reassuring points:
- It is a nerve, not a tumor. Despite the name 'neuroma,' it is an irritated, thickened nerve, not a cancer. The concern is symptoms and function, not malignancy.
- Shoes matter most at first. The single highest-yield change is roomier, lower-heeled footwear with a metatarsal pad. Many cases settle with footwear and a pad before any injection or surgery.
This page is general educational content authored by Dr. Lee. It is not a substitute for individual medical advice. Every patient's case is different, book a consultation to discuss yours.